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Fine-needle aspiration cytology of adrenal masses: A re-assessment with histological confirmation

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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. Aim: To analyze the diagnostic performance of adrenal FNA in subjects with an available histological confirmation. Subjects and 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 nondiagnostic 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.

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Authors and Affiliations

  1. Division of Endocrinology, Department of Clinical Medicine and Applied Biotechnologies, Polytechnic University of Marche, Torrette, Ancona, Italy

    G. Tirabassi, M. Boscaro & G. Arnaldi MD

  2. Department of Endocrinology, Barts and the London Medical School, Queen Mary, University of London, London, UK

    B. Kola

  3. Department of Cytopathology, Regional Hospital, Torrette, Italy

    M. Ferretti

  4. Scientific-Technological Area, INRCA (Italian National Institute on Aging), Ancona, Italy

    R. Papa

  5. Department of Internal Medicine and Medical Specialities, San Marino Hospital, San Marino, San Marino, Italy

    T. Mancini

  6. Endocrinology Division, Department of Medical and Surgical Sciences, Hospital/University of Padova, Padova, Italy

    F. Mantero

  7. Section of Pathological Anatomy, Polytechnic University of Marche, Torrette, Ancona, Italy

    M. Scarpelli

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  1. G. Tirabassi
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  2. B. Kola
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  3. M. Ferretti
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  4. R. Papa
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  5. T. Mancini
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  6. F. Mantero
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  7. M. Scarpelli
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  8. M. Boscaro
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  9. G. Arnaldi MD
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Correspondence to G. Arnaldi MD.

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Tirabassi, G., Kola, B., Ferretti, M. et al. Fine-needle aspiration cytology of adrenal masses: A re-assessment with histological confirmation. J Endocrinol Invest 35, 590–594 (2012). https://doi.org/10.3275/8010

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