Incidentaloma other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]

Overview

Fine-needle aspiration biopsy may be helpful in the diagnosis of incidentaloma. It can distinguish between an adrenal tumor and a metastatic tumor. In a patient with a known primary malignancy, performing a diagnostic CT-guided FNA biopsy may be indicated. The FNA biopsy of a pheochromocytoma may result in hemorrhage and hypertensive crisis. So, excluding pheochromocytoma with biochemical testing is necessary before any procedure.

Other Diagnostic Studies

  • In a patient with a known primary malignancy, performing a diagnostic CT-guided FNA biopsy may be indicated.
  • Adrenal biopsy would not be needed if the patient was already known to have a widespread metastatic disease.[2]

References

  1. Mazzaglia PJ, Monchik JM (2009). "Limited value of adrenal biopsy in the evaluation of adrenal neoplasm: a decade of experience". Arch Surg. 144 (5): 465–70. doi:10.1001/archsurg.2009.59. PMID 19451490.
  2. Jhala NC, Jhala D, Eloubeidi MA, Chhieng DC, Crowe DR, Roberson J; et al. (2004). "Endoscopic ultrasound-guided fine-needle aspiration biopsy of the adrenal glands: analysis of 24 patients". Cancer. 102 (5): 308–14. doi:10.1002/cncr.20498. PMID 15376200.
  3. Kumar R, Dey P (2016). "Fine-needle aspiration cytology of non-neoplastic adrenal pathology". Diagn Cytopathol. 44 (6): 472–6. doi:10.1002/dc.23467. PMID 26956774.
  4. Vanderveen KA, Thompson SM, Callstrom MR, Young WF, Grant CS, Farley DR; et al. (2009). "Biopsy of pheochromocytomas and paragangliomas: potential for disaster". Surgery. 146 (6): 1158–66. doi:10.1016/j.surg.2009.09.013. PMID 19958944.
  5. Arellano RS, Harisinghani MG, Gervais DA, Hahn PF, Mueller PR (2003). "Image-guided percutaneous biopsy of the adrenal gland: review of indications, technique, and complications". Curr Probl Diagn Radiol. 32 (1): 3–10. doi:10.1067/cdr.2003.120002. PMID 12574782.

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