Left Adrenal Gland Analysis in Lung Cancer Patients Using the Endobronchial Ultrasound Scope: A Feasibility Trial

Background: In lung cancer patients, the adrenal glands are predilection sites for distant metastases. Esophageal endoscopic ultrasound – fine-needle aspiration (EUS-FNA) is a minimally invasive and accurate method for left adrenal gland (LAG) analysis but requires a conventional gastrointestinal echoendoscope. Complete endobronchial and esophageal mediastinal nodal staging can be achieved by just a single endobronchial ultrasound (EBUS) scope, introducing it into the esophagus (EUS-B) following the endobronchial procedure. Whether the LAG can also be assessed with the EBUS scope is unknown. Objectives: The aim of the study was to investigate the feasibility of identifying the LAG with the EBUS scope. Methods: We conducted a retrospective analysis of lung cancer patients who underwent EBUS and EUS-B for mediastinal staging and LAG assessment between January 2013 and May 2015. Results: A total of 143 patients with (suspected) lung cancer were investigated by the combination of EBUS and EUS-B. In 68 of the 80 patients (85%) in whom an attempt was made to identify the LAG, it was feasible to transgastrically detect the LAG with the EBUS scope. In 9 patients with endosonographic signs of malignant involvement, diagnostic transgastric FNAs were obtained in Received: August 18, 2015 Accepted: January 8, 2016 Published online: March 2, 2016 Laurence M.M.J. Crombag Department of Pulmonology, F5-144, Academic Medical Centre University of Amsterdam, Meibergdreef 9 NL–1105 AZ Amsterdam (The Netherlands) E-Mail l.m.crombag @ amc.nl © 2016 The Author(s) Published by S. Karger AG, Basel 0025–7931/16/0913–0235$39.50/0 www.karger.com/res Th is article is licensed under the Creative Commons AttributionNonCommercial-NoDerivatives 4.0 International License (CC BYNC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any distribution of modifi ed material requires written permission. D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /2 6/ 20 17 1 0: 46 :2 8 A M