Cytological Assessment of Adrenal Tumours: Insights From 22-Years Single Centre Experience

IF 2.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Clinical Endocrinology Pub Date : 2025-04-23 DOI:10.1111/cen.15254

Ana Carasel, Jan Calissendorff, C. Christofer Juhlin, Henrik Falhammar

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引用次数: 0

Abstract

Objective

The incidence of adrenal tumours has increased in the last decades, mainly due to increased use of imaging. The diagnostic evaluation of adrenal masses can be complex and, in some cases, necessitates cytological evaluation. However, concerns remain regarding the potential complications associated with adrenal gland biopsy.

Design

We conducted a retrospective cohort study to evaluate the safety and diagnostic effectiveness of cytology in patients who underwent fine-needle aspiration (FNA) of adrenal glands at Karolinska University Hospital in Stockholm, Sweden, between 2000 and 2022. The aim was to evaluate the accuracy of the sample and the complication rate.

Patients and Measurements

A total of 241 patients and 251 FNAs were included, with 10 patients undergoing two FNAs each. Data on clinical, radiological and laboratory presentation was collected and corelated with cytological findings and outcomes.

Results

Diagnostic FNA was obtained in 90% of patients (n = 217) with endoscopic ultrasound technique being most successful (95.8%), followed by CT (88.7%) and transabdominal ultrasound technique (86.7%). The sensitivity and the specificity were 93.8% respectively 96.7%. More than half of the FNA samples (52.7%) indicated a diagnosis consistent with metastases to the adrenal gland. The complication rate was 7.9% (n = 20). Based on the FNA results, adrenalectomy was performed on 13.6%, while 52.8% of the patients with benign findings were managed conservatively. Chemotherapy was started for 78.7% of patients with malignant findings.

Conclusion

FNA of the adrenal glands is a safe, minimally invasive diagnostic procedure that can be useful in the assessment of adrenal lesions.

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肾上腺肿瘤的细胞学评估：来自22年单一中心经验的见解。

目的：近几十年来，肾上腺肿瘤的发病率有所增加，主要是由于影像学的使用增加。肾上腺肿块的诊断评估可能是复杂的，在某些情况下，需要细胞学评估。然而，对肾上腺活检相关的潜在并发症的关注仍然存在。设计：我们进行了一项回顾性队列研究，以评估2000年至2022年期间在瑞典斯德哥尔摩卡罗林斯卡大学医院接受肾上腺细针穿刺（FNA）患者细胞学检查的安全性和诊断有效性。目的是评估样本的准确性和并发症发生率。患者和测量：共纳入241例患者和251例FNAs，其中10例患者分别接受2例FNAs。收集临床、放射学和实验室表现的数据，并将其与细胞学结果和结果相关联。结果：90%的患者（217例）获得诊断性FNA，其中超声内镜检查成功率最高（95.8%），其次是CT检查（88.7%）和经腹超声检查（86.7%）。敏感性为93.8%，特异性为96.7%。超过一半的FNA样本（52.7%）的诊断与肾上腺转移一致。并发症发生率为7.9% （n = 20）。根据FNA结果，13.6%的患者行肾上腺切除术，而52.8%的良性患者行保守治疗。78.7%的恶性肿瘤患者开始化疗。结论：肾上腺FNA是一种安全、微创的诊断方法，可用于评估肾上腺病变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Endocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

3.10%

发文量

192

审稿时长

1 months

期刊介绍： Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.