Fine-needle aspiration biopsy of the adrenal glands: A ten-year experience

We report on our experience in FNA biopsy of the adrenal gland: 177 biopsies performed in the last 10 years. Cytologic diagnoses were divided into four groups: nondiagnostic aspirates (28%), primary adrenal lesions (13%), metastatic neoplasms (33%), and negative cases with known extra-adrenal malignancies (25%). Among diagnostic smears and excluding the latter group, the procedure was 100% specific for malignancy, and 98% of the lesions were correctly diagnosed. There were no known false-positive or false-negative samples. Quality of diagnosis improves with careful smearing (avoids artifacts) and immediate evaluation (raises adequacy rates) by the pathologist. Although the primary or secondary nature of most adrenal masses is readily apparent, it is essential to correlate the clinical, laboratory, and cytologic findings to reach the correct diagnosis. Furthermore, we believe that the primary site of many adrenal metastases must be defined on the basis of clinical data. Diagn. Cytopathol. 1999;21:92-97.