IDDF2018-ABS-0019 Endoscopic ultrasound-guided fine-needle aspiration of enlarged adrenals in patients with pyrexia of unknown origin: a single centre experience of 52 cases

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Abstract

Background

Fine needle aspiration (FNA) of adrenals is needed in patients with pyrexia of unknown origin (PUO) and adrenal enlargement in the absence of other diagnostic clues. Adrenals are easily accessible by endoscopic ultrasound (EUS) due to proximity; however, there is no systemic study available. The aim of this study was to evaluate the diagnostic yield and safety of EUS-FNA of enlarged adrenal in patients with pyrexia of unknown origin (PUO).

Methods

Data were analysed from October 2010 to September 2016 at a single tertiary care centre in North India. EUS FNA of enlarged adrenals was done in fifty-two patients for the etiological diagnosis of PUO in whom a definitive diagnosis could not be made with other means.

Results

The mean age was 48±14 years; 36 were males, and 16 were females. EUS-FNA was done from left adrenal in 50 patients and from right adrenal in 2 patients. Technical success was achieved in 100% cases. The 19 G needle was used in majority (75%) due to the presence of necrotic areas in adrenals; median numbers of passes were 2. The cytopathological diagnoses were tuberculosis (n=36), histoplasmosis (n=13), lymphoma (n=2), and metastasis from undiagnosed neuroendocrine tumour of lung (n=1). Thus a diagnosis could be made in 52/52 (100%) patients. None of the patients had any procedure-related complications.

Conclusions

EUS-FNA is a safe and effective method for evaluating aetiology of PUO in patients with adrenal enlargement.

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