@article {Orzechowski5121, author = {Stanis{\l}aw Orzechowski and Maciej Gnass and Joanna Sola and Monika Lis and Monika Skrobot and Pawe{\l} Gw{\'o}{\'z}d{\'z} and Anna Filarecka and Jerzy Soja and Juliusz Pankowski and Artur Bartczak and Artur Szlubowski}, title = {Endosonography for left adrenal gland assessment in lung cancer patients {\textendash} 10 years experience}, volume = {56}, number = {suppl 64}, elocation-id = {5121}, year = {2020}, doi = {10.1183/13993003.congress-2020.5121}, publisher = {European Respiratory Society}, abstract = {Introduction: In staged lung cancer patients (LCP) left adrenal glands (LAG) suspected for distant metastases (M1b/c) based on CT or PET-CT require further invasive evaluation. Only few studies have shown utility of EUS-FNA and particularly EUS-b-FNA as minimally invasive endoscopic methods for LAG analysis.Methods: A single center retrospective study in consecutive LCP was performed from 2009 to 2019. Following complete minimally invasive mediastinal staging by use of single ultrasound bronchoscope EBUS or two scopes, the enlarged LAG (body size\>10mm) was examined and sampled by EUS-b-FNA or EUS-FNA.Results: From 2596 LCP staged by complete endosonography, 142 (5.5\%) of them (M: 88, F:54, mean age 64.7) had enlarged LAG and were biopsied by conventional EUS-FNA in 52 (36.6\%) and by EUS-b-FNA in 90 (63.4\%). Metastases were found in 73/142 (51.4\%) of biopsied LAGs. Strong correlation with gland diameter (P\<0.001) and predominance of Adenoca 44/73 (60.3\%) were observed. Regarding histology metastases to LAGs were found in 76.9\% of SCLC, 66.7\% of Adenoca, 56.3\% of NSCLC and 17.5\% of SCC. A specificity and PPV for both methods were 100\%. A sensitivity, accuracy and NPV for EUS-FNA were 91.7\%, 96.2\%, 93.3\% and for EUS-b-FNA 88\%, 93.3\% and 87\%, respectively and no significant differences in yield for both methods were noted (P=0.62, 0.44, 0.35). No severe complications after all biopsies were observed. A six months clinical follow up was obtained in all negative LCP with enlarged LAG.Conclusions: After our study EUS-b-FNA seems to be a method of choice for LAG analysis in LCP.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 5121.This abstract was presented at the 2020 ERS International Congress, in session {\textquotedblleft}Respiratory viruses in the "pre COVID-19" era{\textquotedblright}.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).}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/56/suppl_64/5121}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }