VHJOE- Featured Movie: The Left Adrenal

Visible Human: The Left Adrenal

John C. Deutsch , M.D. (St. Mary's Duluth Clinic)

VHJOE Editor:

John Deutsch, MD
St. Mary's Duluth Clinic

Editorial Board:

Manoop S. Bhutani, MD
University of Texas
Medical Branch

William R. Brugge, MD
Massachusetts General Hospital

Peter R. McNally, DO
Denver, CO

Thomas J. Savides, MD
University of California,
San Diego

C. Mel Wilcox, MD
University of Alabama, Birmingham

This issues featured movie shows the left adrenal in a coronal orientation Video 1. In this video, one can see the left kidney, left adrenal pancreas, stomach and the splenic vein. Figures 1 and 2 show selected frames from the video in which the left adrenal and other organs are labeled. The left adrenal is an important feature to be visualized during an EUS examination. Primary tumors occur, and metastatic tumors are not infrequent¹. EUS allows biopsy of the left adrenal, even when the lesions are small^1,2. Video 2 shows an EUS biopsy of an abnormal left adrenal which was found to contain a primary adrenal neoplasm, and Video 3 shows the biopsy of a left adrenal which was found to harbor metastatic lung cancer.

The adrenal can be interrogated using the Visible Human data set. Figure 3 shows an axial image through the left adrenal. One can enter the Visible Human data by clicking on the link, and this region can be further explored by interested readers


Figure 1	Figure 2	Figure 3: Click here to launch Interactive Atlas


Video Clip 1: Visible Human Data showing the left adrenal from a coronal orientation. Larger Versions: Low Resolution (294 KB) High Resolution (3.0 MB)	Video Clip 2: An EUS guided biopsy of a primary adrenal carcinoma. Larger Versions: Low Resolution (104 KB) High Resolution (1.4 MB)	Video Clip 3: An EUS guided biopsy of a 2 by 1 cm adrenal mass in a patient being staged for lung cancer. Larger Versions: Low Resolution (295 KB) High Resolution (3.0 MB)

We encourage readers to use the Visible Human dataset as an educational aid and for their own curiosity

References

1. Ringbaek TJ, Krasnik M, Clementsen P, Skov BG, Rasmussen EN, Vilmann P. Transesophageal endoscopic ultrasound/fine-needle aspiration diagnosis of a malignant adrenal gland in a patient with non-small cell lung cancer and a negative CT scan.Lung Cancer. 2005 May;48(2):247-9. Epub 2004 Dec 29 <Related link>

2. Jhala NC, Jhala D, Eloubeidi MA, Chhieng DC, Crowe DR, Roberson J, Eltoum I. Endoscopic ultrasound-guided fine-needle aspiration biopsy of the adrenal glands: analysis of 24 patients. Cancer. 2004 Oct 25;102(5):308-14. <Related link>