Adrenal Bez Kitlelerinde Ultrasonografi Eþliðinde Yapýlan Ýnce Ýðne Aspirasyon Biyopsisinin Etkinliði

Ýt was planned to investigate the efficiency of US-guided fine-needle aspiration biopsy betvveen 1992 and 2004 in 33 patients who had lesions in adrenal glands in our department. Of 22 patients who were follovved-up, 4 were vvomen and 18 were men (women/men rate= 22.2%); mean age was 54.0 ± 13.0 years, ranging betvveen 27 and 75 years. Ýn 63.6% (14 patients) and 36.4% (8 patients) were located in the right and left adrenal glands respectively. The diameters of lesions varied betvveen 2.5 cm and six cm. Evaluation of success (accuracy) was realized in 22 patients having definitive diagnosis. Ali 5 patients (23.0%) diagnosed, inadequate material, was accepted false negative. The diagnosis of lipoma was established, but second tissue diagnosis was vvell-differentiated liposarcoma. The diagnosis of suspected malign ývas found successful if outcome was maiignant pathologically or clinically. Among nine patients evaluated as maiignant and six patients suspected maiignant there tvas no patient who was found benign vvith pathologic or clinical diagnosis, false positivety. The specificity was 100%. Ali the patients of seven patients vvith metastasis and six patients suspected maiignant had metastases originated from various organs. Totally six patients were false negative. Of two patients who were diagnosed benign one was lipoma falsely, the other adenoma accurateiy. The sensitivity and accuracy were 71.4% and 73.0% respectively. There was detected no difference in the success due to gender and right-left localizations (p> 0.05). Percutaneous US-guided fine-needle aspiration biopsy is a saf e and effective method aiming to diagnose in the patients vvith adrenal gland masses greater than 2.5 cm. Ýt should be repeated vvith CT-guided or vvith endoscopic US-guided, if needed in left adrenal gland, if it is not concluded.

The Efficacy of US-Guided Fine-Needle Aspiration Biopsy in Adrenal Masses

Çalýþmamýzda, kliniðimizde son 12 yýlda (1992-2004) yapmýþ olduðumuz adrenal bez tezyonu olan 33 olguda, yalnýzca US eþliðindeki ince iðne aspirasyon biyopsisinin etkinliðini araþtýrmayý planladýk. Takip sonucu olan 22 olgunun, 4’ü kadýn, 18’i erkek (kadýn/erkek oraný= %22.2) ve yaþ ortalamasý 54.0 ± 13.0 yaþ (27-75 yaþ) idi. Yirmi iki olguda (kayýp 11 olgu dýþýnda) lezyonlarýn %63.6’sý (14 olgu) sað adrenal bez, %36.4’ü (8 olgu) sol adrenal bez yerleþimliydi. Lezyonlarýn boyutlarý 2.5-6 cm arasýnda deðiþiyordu. Olgulardan kesin taný elde edilen 22 olguda baþarý (doðruluk) deðerlendirmesi yapýldý. Yetersiz materyal sonucu alýnan 5 (%23.0) olgu, yanlýþ negatif kabul edildi. Bir olguda lipom tanýsý kondu, ancak ikinci doku tanýsý düþük ‘grade’li liposarkom idi. Þüpheli malign tanýsý, patolojik veya klinik olarak malign çýktýðýnda, baþarýlý olarak kabul edildi. Malign olarak deðerlendirilen dokuz olgu ve þüpheli malign tanýsý alan altý olgudan, daha sonra patolojik taný veya klinik bulgularla benign olduðu anlaþýlan yanlýþ pozitif hiçbir olgu olmadý. Özgüllük %100 bulunmuþtur. Yedi metastaz ve altý þüpheli malign olgunun tümü, deðiþik organlardan kaynaklanan metastaz olarak bulunmuþtur. Toplam altý olgu yanlýþ negatif olarak deðerlendirilmiþtir. Benign tanýsý alan iki olgudan biri yanlýþlýkla lipom, diðeri doðru olarak adenom tanýsýný almýþtýr. Duyarlýlýk %71.4 ve doðruluk %73.0 idi. Cinsiyet ve sað-sol lokalizasyona göre, baþarý farklý bulunmamýþtýr (p> 0.05). Adrenal bezde, > 2.5 cm kitlesi olan hastalarda taný koyabilmek amacýyla, perkütan US kýlavuzluðunda yapýlan ince iðne aspirasyon biyopsisi güvenilir ve etkin bir yöntemdir. Sonuç alýnamazsa, bilgisayarlý tomografi veya sol adrenal bezde gerekirse endoskopik US kýlavuzluðunda tekrarlanmalýdýr.