Extraneous cells of hepatic origin in adrenal fine needle aspiration as a diagnostic pitfall: a case report.
BACKGROUND
The fine needle aspiration (FNA) cytologic evaluations of most adrenal lesions are straightforward. However, there are diagnostic pitfalls to be avoided.


METHODS
A 34-year-old, pregnant woman was discovered to have an asymptomatic, right upper abdominal mass on ultrasound examination. After delivery, computed tomography-guided FNA showed bland epithelial cells, and a diagnosis of adrenal cortical adenoma was made. However, subsequent resection showed a myelolipoma of the adrenal gland.


CONCLUSIONS
This case illustrated 2 cytodiagnostic pitfalls in adrenal fine needle aspirates. First, the myeloid cells characteristic of a myelolipoma were not present in the FNA smears because a large portion of the lesion was composed of fibroadipose tissue. Second, extraneous, benign cells of hepatic origin were misinterpreted as adrenal cortical adenoma cells.
Chen
Karl T K
KT
Department of Pathology, Saint Agnes Medical Center, Fresno, California 93720, USA. chenka@samc.com
D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000473:pathology; D000311:Adrenal Glands / Q000473:pathology; D018246:Adrenocortical Adenoma / Q000175:diagnosis; D000328:Adult; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D022781:Hepatocytes / Q000473:pathology*; D006801:Humans; D018209:Myelolipoma / Q000175:diagnosis* / Q000473:pathology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed