Adrenal biopsy (PG044)

Adrenal biopsy — is a procedure to obtain a sample of adrenal gland tissue for further histological examination. It is most often performed by fine-needle aspiration (FNA) under the control of computed tomography (CT) or ultrasound (US). The study code PG044 is critically important for the differential diagnosis of neoplasms, especially in patients with a history of cancer.

Research objective: The main task is morphological verification of the nature of the detected formation. Since the adrenal glands are a frequent site of metastasis of tumors of other localizations (lungs, breast, kidneys), biopsy allows to distinguish metastasis from the primary tumor of the gland or benign adenoma.

What does the pathologist evaluate:

• Fabric type: determining whether the cells originate from the adrenal cortex or medulla.

• Signs of malignancy: Evaluation of cells for atypia, which is characteristic of adrenocortical cancer.

• Metastasis verification: comparison of cell structure with the primary cancer focus in other organs using immunohistochemical markers (if necessary).

• Hormonal activity (indirectly): identification of structural features characteristic of pheochromocytoma (brain tumor).

• Inflammatory and infectious processes: exclusion of adrenal tuberculosis or specific fungal lesions.

Clinical significance: The conclusion of the pathologist under the code PG044 determines the treatment strategy: from dynamic observation of a benign adenoma ("incidentaloma") to immediate surgical intervention or the appointment of chemotherapy. This study helps to avoid complex operations in cases where the formation is inactive and benign.

When is it prescribed:

• detection of adrenal tumors using CT or MRI in patients with a history of cancer;

• suspicion of adrenocortical cancer with rapid tumor growth;

• differential diagnosis between adenoma and metastatic lesion;

• detection of volumetric formations of unexplained nature, accompanied by hormonal disorders.