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I always wonder how right adrenal FNA or biopsy can be done? It is strictly adhered to vena cava and hwo to avoid vena cava to prick the gland? Also, someitmes it gets difficult to moe the renal artery out of the way to FNA the left adrena; any tips?
Comments
I don’t do these very often any more given the urine catecholamine test for pheochromocytoma because usually we are checking for carcinoma vs pheo. The right adrenal is more difficult but with heavy sedation I push the body wall in sdep 14 position down to the right adrenalwiht my left hand wiht probe and stay dorsal near th elumbar to push th ecolon out of the way. 25 gauge 1.5 inch not larger as adrenal tumors are mushy and slow passes into the parenchyma at slightly different angles to get fresh tissue each time. once you have your sample keep deep pressure on the adrenal with the same push for about 3 min as hematomas can form.
Moroever i dont do these often any more because if they are growing or starting to invade they just need to come out.