Alternative Names biopsy - adrenal gland, adrenal gland biopsy
Definition There are two adrenal glands in the body, one on top of each kidney. These glands produce a variety of hormones that affect almost all of the body's functions. An adrenal biopsy involves taking a sample of tissue, usually from only one adrenal gland.
Who is a candidate for the procedure? This procedure is usually done when an abnormal growth or mass is seen in one, or rarely both, of the adrenal glands. This growth or mass may represent a tumour or an infection. The adrenal glands can only usually be seen during special x-ray tests, such as an abdominal CT scan.
How is the procedure performed? An adrenal biopsy may be done in one of two ways, both usually in a hospital. The first way involves using a needle inserted through the skin of the back. This is done with the help of a CT scan or other x-ray test to guide placement of the needle.
Local anaesthesia is used to prevent the person from feeling pain. A medication to relax the person may also be given if needed. While the doctor looks at live images from the x-ray machine, he or she inserts the needle into the back. The needle is placed into the abnormal area of the gland and a small piece of tissue is removed with the needle. The needle is then taken out and a bandage is placed over the puncture site.
The other way a sample of the adrenal gland may be obtained is through surgery, under general anaesthesia. A cut is made into the back or abdomen and the surgeon looks at the gland directly. A piece of the gland can then be removed and sent to the laboratory. The laboratory often analyses the piece of tissue while the person is still asleep. If the tissue turns out to be cancer, surgery can then be done right away to avoid a second operation in the future.
What is involved in preparation for the test? Because preparation for this procedure can vary, a person should ask his or her doctor for instructions.
What happens right after the procedure? After an x-ray guided biopsy, a person usually requires little, if any, time to recover. If a relaxing medication was given, the person often must be monitored for an hour or two until it has started to wear off. Once the person feels okay, he or she may be able to go home if there is no other reason for them to be in the hospital. If the person does go home and was given medication, someone else must drive them home. This is because the medications used to relax people often impair the ability to drive.
After the surgical approach to adrenal biopsy, a person often needs to stay in the hospital for a day or more to recover. He or she is first taken to a surgery recovery room for a few hours, then to the hospital room. In some cases, a person may be able to go home the same day if someone else drives them home.
What happens later at home? People are usually free to return to normal activities the next day after an x-ray-guided biopsy. The bandage applied can usually be left on until it falls off, usually a day or two later. Specific instructions are provided by the hospital staff.
If the sample was obtained during surgery, recovery usually takes slightly longer. In this case, the surgeon gives specific home care instructions before a person leaves the hospital. If a person notices breathing trouble, bleeding, fevers or chills after either type of biopsy, the doctor should be contacted.
The results of the biopsy are usually available within a few days. The tissue must be processed and examined by the laboratory. The biopsy may reveal:
a benign tumour. This is a tumour that is not cancer, though it may cause problems in the body if it grows too big or secretes excess hormones.
cancer, which may be from the adrenal gland or a metastasis, which is a cancer that has spread from another part of the body
What are the potential complications after the procedure? An x-ray guided biopsy may sometimes cause a small hole in the lungs that can cause problems with breathing. Both methods of biopsy can result in infection, bleeding, and reactions to any analgesics used. Death is extremely rare, but is possible with either method.
Author: Adam Brochert, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 6/06/2005 Contributors Potential conflict of interest information for reviewers available on request
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