Abstract
Background: The left adrenal gland (LAG) is a preferred location for metastases in lung cancer and endoscopic endobronchial ultrasound (EUS-B) is a new procedure to evaluate the LAG in routine minimal invasive staging with the option of fine needle aspiration (FNA) for histological verification.
Objective: The aim of the present study was to determine safety and value of EUS-B-FNA and to identify predictors of LAG metastasis.
Methods: From January to December 2021 the LAG has been additionally evaluated with EUS-B in patients suspected of new onset or relapse of lung cancer referred for minimal invasive staging. FNA was performed if the LAG could be localised and appeared enlarged or suspicious either endosonographically or in CT/PET-CT. All procedures have been done in general anaesthesia by highly experienced bronchoscopists using an EBUS-scope only. Predictors for LAG metastasis were retrospectively evaluated. In a multi-disciplinary conference, the final LAG status was defined.
Results: EUS-B of the LAG has been performed in 686 cases. In 137 cases (55 female, 68 years mean) the LAG was classified as suspicious by EUS-B or CT/PET-CT and FNA was performed. LAG metastasis was histologically confirmed in 39 cases (28.5 %) with unremarkable CT/PET-CT findings in 5 (12.8%) of them. In 97 cases histology was negative. In one patient tissue acquisition was insufficient. No complications were recorded. As predictors for LAG metastasis have been identified: histology of SCLC or Adenocarcinoma and N3 situation.
Conclusions: EUS-B-FNA is a valuable and safe procedure to clarify the status of the LAG, particularly in patients with CT / PET-CT findings indicative for metastasis.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 3904.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
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