title: Endoscopic ultrasound-guided fine-needle aspiration of the adrenal glands: analysis of 21 patients.
abstract: OBJECTIVE
  Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology of adrenal masses helps in etiological diagnosis. The aim of this study was to evaluate the diagnostic yield of EUS-FNA of adrenal masses in cases where other imaging methods failed and/or were not feasible.
  
  
  METHODS
  Twenty-one consecutive patients with adrenal masses, in whom adrenal FNA was performed because conventional imaging modalities failed and/or were not feasible, were prospectively evaluated over a period of 3 years.
  
  
  RESULTS
  Of the 21 patients (mean age, 56±12.2 years; male:female ratio, 2:1), 12 had pyrexia of unknown origin and the other nine underwent evaluation for metastasis. The median lesion size was 2.4×1.6 cm. Ten patients were diagnosed with tuberculosis (shown by the presence of caseating granulomas [n=10] and acid-fast bacilli [n=4]). Two patients had EUS-FNA results suggestive of histoplasmosis. The other patients had metastatic lung carcinoma (n=6), hepatocellular carcinoma (n=1), and adrenal lipoma (n=1) and adrenal myelolipoma (n=1). EUS results were not suggestive of any particular etiology. No procedure-related adverse events occurred.
  
  
  CONCLUSIONS
  EUS-FNA is a safe and effective method for evaluating adrenal masses, and it yields diagnosis in cases where tissue diagnosis is impossible or has failed using conventional imaging modalities.
authors.affiliation: Department of Gastroenterology, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Puri
authors.affiliation: Department of Gastroenterology, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, India.
authors.forename: Ragesh Babu
authors.initials: RB
authors.lastname: Thandassery
authors.affiliation: Department of Gastroenterology, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, India.
authors.forename: Narendra S
authors.initials: NS
authors.lastname: Choudhary
authors.affiliation: Department of Gastroenterology, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, India.
authors.forename: Hardik
authors.initials: H
authors.lastname: Kotecha
authors.affiliation: Department of Gastroenterology, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, India.
authors.forename: Smruti Ranjan
authors.initials: SR
authors.lastname: Misra
authors.affiliation: Department of Gastroenterology, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, India.
authors.forename: Suraj
authors.initials: S
authors.lastname: Bhagat
authors.affiliation: Department of Gastroenterology, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Paliwal
authors.affiliation: Department of Gastroenterology, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, India.
authors.forename: Kaushal
authors.initials: K
authors.lastname: Madan
authors.affiliation: Department of Gastroenterology, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, India.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Saraf
authors.affiliation: Department of Cytopathology, Medanta The Medicity, Gurgaon, India.
authors.forename: Haimanti
authors.initials: H
authors.lastname: Sarin
authors.affiliation: Department of Cytopathology, Medanta The Medicity, Gurgaon, India.
authors.forename: Mridula
authors.initials: M
authors.lastname: Guleria
authors.affiliation: Department of Gastroenterology, Medanta Institute of Digestive & Hepatobiliary Sciences, Medanta, India.
authors.forename: Randhir
authors.initials: R
authors.lastname: Sud
keywords: Adrenal mass; Endosonography; Fine-needle aspiration cytology; Tuberculosis
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