{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:26:16Z","timestamp":1782602776481,"version":"3.54.5"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,6,21]],"date-time":"2019-06-21T00:00:00Z","timestamp":1561075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Historically, sampling of adrenal lesions has been performed by percutaneous image\u2010guided fine\u2010needle aspiration (FNA) biopsy. Endoscopic ultrasound guided (EUS)\u2010FNA of the adrenals was first employed at Cleveland Clinic ~10\u2009years ago. We report a two\u2010decade experience of adrenal FNA in our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An electronic retrieval identified adrenal FNAs from 1997 to 2017. Data points from each case (diagnosis, method of FNA, age, sex, laterality, needle gauge, size of lesion, adequacy of sample, and histologic follow up) were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our retrieval confirmed 198 adrenal FNAs performed over 20\u2009years. Of these, 90% (179\/198) were percutaneous, and the remaining 10% (19\/198) were collected by EUS. Of the 179 CT guided FNAs, 93% (162\/179) yielded an adequate specimen as compared with an adequacy rate of 89% (17\/19) for EUS\u2010FNAs, with no significant difference in adequacy rates by collection method, <jats:italic>P<\/jats:italic> =\u2009.64 (Fisher's exact). Of all adrenal FNAs, 53% (105\/198) confirmed metastases, 33% (65\/198) showed adrenal cells or primary adrenal neoplasms (85% cortical cells, 14% cortical neoplasia, 1% pheochromocytoma), 8% were inadequate (15\/198), 3% were atypical (7\/198), and 2% were suspicious for malignancy (5\/198).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>FNA of the adrenal glands can be useful in the diagnosis and staging of metastatic neoplasms, as well as in distinguishing primary adrenal cortical from medullary neoplasms and characterizing hematolymphoid and mesenchymal neoplasms. Overall adequacy rates for adrenal cytology are high (92%) with no statistically significant difference between CT\u2010guided (93%) and EUS\u2010FNA adequacy (89%). The majority of our procedures confirmed metastases, sparing patients unnecessary surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.24261","type":"journal-article","created":{"date-parts":[[2019,6,21]],"date-time":"2019-06-21T14:38:40Z","timestamp":1561127920000},"page":"986-992","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Fine\u2010needle aspiration of adrenal lesions: A 20\u2010year single institution experience with comparison of percutaneous and endoscopic ultrasound guided approaches"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6424-2135","authenticated-orcid":false,"given":"Aaron G.","family":"Novotny","sequence":"first","affiliation":[{"name":"Pathology and Laboratory Medicine Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan P.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akeesha A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Cleveland Clinic  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhleen","family":"Chahal","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Cleveland Clinic  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erick M.","family":"Remer","sequence":"additional","affiliation":[{"name":"Imaging Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Cleveland Clinic  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Gmitro","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0153-498X","authenticated-orcid":false,"given":"Charles D.","family":"Sturgis","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine Institute Cleveland Clinic  Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21464"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2015.11.019"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-16-0297"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002749"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.21037\/gs.2017.03.20"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365598509180256"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13117"},{"key":"e_1_2_6_9_1","first-page":"590","article-title":"Fine\u2010needle aspiration cytology of adrenal masses: A re\u2010assessment with histological confirmation","volume":"35","author":"Tirabassi G","year":"2012","journal-title":"J Endocrinol"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.5527\/wjn.v3.i3.92"},{"key":"e_1_2_6_11_1","first-page":"307","article-title":"Endoscopic Untrasound\u2010guided fine\u2010needle aspiration in the diagnosis of adrenal lesions","volume":"29","author":"Patil R","year":"2016","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20498"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(96)70010-X"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2015.48.2.165"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1325988"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.03.017"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2017.05.001"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP.15.S1.1"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000368370"},{"key":"e_1_2_6_20_1","first-page":"83","article-title":"Symptomatic large bilateral adrenal metastases at presentation in small\u2010cell lung cancer: a case report and review","volume":"5","author":"Singh N","year":"2013","journal-title":"J Thorac Dis"},{"key":"e_1_2_6_21_1","first-page":"137","article-title":"Diagnostic and prognostic markers of adrenal cortical carcinoma","volume":"29","author":"Mete O","year":"2018","journal-title":"Am J Surg Pathol"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2013.799222"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fdc.24261","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.24261","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dc.24261","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.24261","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T03:46:57Z","timestamp":1694317617000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.24261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,21]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1002\/dc.24261"],"URL":"https:\/\/doi.org\/10.1002\/dc.24261","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"value":"8755-1039","type":"print"},{"value":"1097-0339","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,21]]},"assertion":[{"value":"2019-02-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}