Utility of rapid on-site evaluation in procurement of adrenal gland tissue biopsies

Diagn Cytopathol. 2022 Dec;50(12):557-564. doi: 10.1002/dc.25036. Epub 2022 Aug 8.


Background: While the number of adrenal biopsies has increased due to more "incidentalomas" were detected by widespread use of imaging studies, there have been very limited studies to evaluate the utility of rapid on-site evaluation (ROSE) in obtaining adequate core needle biopsy (CNB) tissue for diagnosis of adrenal lesions.

Methods: We retrospectively reviewed all percutaneous adrenal CNB cases with available ROSE for a 12-year period in our institute in order to assess the usefulness of ROSE in adrenal CNB sampling.

Results: A total of 83 cases were identified in our database. The majority of cases (52/83, 63%) were diagnosed as metastatic malignancies with the lung being the most common primary site. Adrenal hyperplasia/adenoma was the most common primary adrenal lesion. The concordance between the ROSE interpretations and CNB final diagnoses is 80%. The interpretation errors accounted for majority (11/17, 65%) of the discordant cases.

Conclusion: ROSE assessment during adrenal CNB procedures is a helpful tool for obtaining adequate diagnostic tissue. Pathologists should be familiar with adrenal cytology in order to reduce interpretation errors at ROSE.

Keywords: adrenal glands; concordance; core needle biopsies; rapid on-site evaluation; tissue biopsy smears.

MeSH terms

  • Adrenal Gland Neoplasms* / diagnosis
  • Adrenal Gland Neoplasms* / secondary
  • Adrenal Glands
  • Biopsy
  • Biopsy, Large-Core Needle / methods
  • Humans
  • Hyperplasia
  • Rapid On-site Evaluation*
  • Retrospective Studies