The use of venous catheterization in the diagnosis and localization of bilateral phaeochromocytomas.
OBJECTIVE
The purpose was to assess the value of venous catheter sampling as a method for the location of phaeochromocytomas, particularly when imaging techniques have been equivocal or ambiguous.


METHODS
Venous catheter sampling was carried out in cases of suspected phaeochromocytoma, and compared with samples obtained from other patients without phaeochromocytomas undergoing adrenal venous catheterization.


METHODS
Three patients had phaeochromocytomas (subsequently confirmed by histology); five patients had no clinical or biochemical evidence of phaeochromocytoma but were being investigated for other conditions.


METHODS
Catecholamine and cortisol assays were performed on plasma samples from the adrenal veins and elsewhere, and the noradrenaline to adrenaline (NA:AD) ratio was calculated. RESULTS In patients without phaeochromocytomas the NA:AD ratio was less than 1 in nine adrenal vein samples; in four adrenal vein samples with NA:AD ratio of greater than 1, the presence of a phaeochromocytoma was subsequently confirmed. An extra-adrenal tumour was also located by comparison of central and peripheral venous catecholamine concentrations.


CONCLUSIONS
Venous catheterization with measurements of catecholamines, and determination of NA:AD ratios, allows for the rapid and confident diagnosis and localization of unilateral, bilateral, and extra-adrenal phaeochromocytomas.
Newbould
E C
EC
Department of Endocrinology, St Bartholomew's Hospital, West Smithfield, London, UK.
Ross
G A
GA
Dacie
J E
JE
Bouloux
P M
PM
Besser
G M
GM
Grossman
A
A
D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D002405:Catheterization, Central Venous; D004837:Epinephrine / Q000097:blood; D006801:Humans; D009638:Norepinephrine / Q000097:blood; D010673:Pheochromocytoma / Q000097:blood / Q000175:diagnosis* / Q000473:pathology
D009638:Norepinephrine; D004837:Epinephrine