title: Endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration of the left adrenal gland.
abstract: BACKGROUND
  We reported the application of endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration (FNA) in the local staging of lung cancer. Up to 16% of patients with lung cancer may have adrenal masses. The role of EUS in the characterization of the adrenal gland, as well as EUS-guided FNA of the adrenal gland, has not been described.
  
  
  METHODS
  The adrenal gland was characterized by EUS in 30 of 31 (97%) patients. EUS-guided FNA of an adrenal was performed in one patient. Anatomic correlation and ex vivo images were obtained.
  
  
  RESULTS
  The average dimension was 2.5 cm (range 1.4 to 3.5) x 0.8 cm (range 0.3 to 1.4) with two morphologic types: "seagull" and "elliptical." One patient with lung cancer and a left adrenal mass with a nondiagnostic CT-guided FNA underwent EUS-guided FNA, which established the diagnosis of metastatic adenocarcinoma. Surgery was avoided.
  
  
  CONCLUSIONS
  The left adrenal can be imaged by EUS in almost all patients. EUS-guided FNA may be useful when applied to left adrenal metastatic tumors for tissue diagnosis.
authors.affiliation: Division of Gastroenterology, University of California, Irvine Medical Center, Orange 92668, USA.
authors.forename: K J
authors.initials: KJ
authors.lastname: Chang
authors.forename: R A
authors.initials: RA
authors.lastname: Erickson
authors.forename: P
authors.initials: P
authors.lastname: Nguyen
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000556:secondary*; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D000311:Adrenal Glands / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged