title: Fine-needle aspiration cytology of adrenal masses: a re-assessment with histological confirmation.
abstract: BACKGROUND
  Fine-needle aspiration (FNA) of adrenal masses is a method currently indicated in lesions suspected of being extra-adrenal in origin; even though its diagnostic reliability has already been determined in many studies, few have used histological examination obtained after adrenalectomy for diagnostic confirmation.
  
  
  OBJECTIVE
  To analyze the diagnostic performance of adrenal FNA in subjects with an available histological confirmation.
  
  
  METHODS
  Fifty subjects (26 benign adrenal lesions, 9 primary malignant lesions, and 15 metastatic lesions) who had undergone ultrasound (US)-guided adrenal FNA and then adrenalectomy were re-analyzed retrospectively.
  
  
  RESULTS
  FNA guaranteed a sensitivity of 85.7% and a specificity of 100% in all subjects; after having divided the subjects into oncologic and non-oncologic groups, the sensitivity of the test in oncologic patients (100%) increased significantly compared to non-oncologic (57.1%) with no difference in specificity (100% in both groups). Considering also non-diagnostic samples in our analysis (no.=11; 22% of all samples studied), FNA correctly diagnosed malignancy only in 75% of the cases and benignancy only in 66.6%; however, even after including non-diagnostic samples, the percentage of correct malignancy diagnosis remained significantly higher in oncologic (93.3%) than in non-oncologic patients (44.4%) without significant statistical difference between the 2 groups regarding the percentage of correct benignancy diagnosis (respectively 100% and 63.6%).
  
  
  CONCLUSIONS
  Our study, based on histological confirmation, underlines the low discriminant value of US-guided adrenal FNA, though the method may have value in oncologic patients.
authors: Division of Endocrinology, Department of Clinical Medicine and Applied Biotechnologies, Polytechnic University of Marche, Torrette, Ancona, Italy.
authors: G
authors: G
authors: Tirabassi
authors: B
authors: B
authors: Kola
authors: M
authors: M
authors: Ferretti
authors: R
authors: R
authors: Papa
authors: T
authors: T
authors: Mancini
authors: F
authors: F
authors: Mantero
authors: M
authors: M
authors: Scarpelli
authors: M
authors: M
authors: Boscaro
authors: G
authors: G
authors: Arnaldi
mesh_terms: D000307:Adrenal Gland Diseases / Q000145:classification / Q000175:diagnosis*; D044963:Biopsy, Fine-Needle; D003581:Cytodiagnosis; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity