TY - JOUR T1 - Assessment of the left adrenal gland using an EBUS scope JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - 2002 AU - Laurence Crombag AU - Peter Bonta AU - Jouke Annema Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/2002.abstract N2 - Introduction: In lung cancer patients, the left adrenal adrenal gland (LAG) is a predilection site for distant metastases. Esophageal endoscopic ultrasound (EUS), using a conventional GI endoscope, is an accurate method to assess the LAG. Complete endosonographic mediastinal investigation [endobronchial ultrasound (EBUS) combined with EUS] is the standard for mediastinal nodal staging. Reports show that complete endosonongraphic mediastinal staging can be performed using a single EBUS scope by introducing it in the esophagus after the EBUS procedure. Whether the EBUS scope is also suitable for transgastric LAG analysis is unknown.Aim: To investigate the feasibility to detect the LAG with an EBUS scope.Method: Retrospective analysis of patients who underwent complete endosonographic mediastinal and LAG assessment with a single EBUS scope.Results: 16 patients [(suspected) lung cancer (n=10), sarcoidosis (n=3), or mediastinal masses (n=3)] with normal sized (CT) and FDG-PET negative LAG were investigated with an EBUS scope in patients lying in supine position. In 12/16 patients (75%) the LAG was clearly visualized. In one patient, with a slightly enlarged body, aspirates revealed normal adrenal gland tissue. In 4 patients the LAG was not found possibly due to shortness of the scope or poor contact between ultrasound transducer and stomach wall.Conclusion: The EBUS scope allows identification of the LAG in the majority of patients.Implication: Complete mediastinal staging including LAG analysis using a single EBUS scope seems feasible. In case large studies, including fine needle aspiration, confirm these initial findings, endosonographic N2 and M1 staging can be performed in a cost-effective single scope procedural setting. ER -