1
|
Su T, Zhang X, Wang R, Wang J, Xu H, Xu C, Zhao S. The Role of Endoscopic Ultrasound-guided Fine-needle Aspiration of Pelvic Lesions: A Meta-analysis. J Clin Gastroenterol 2024; 58:232-241. [PMID: 38227844 DOI: 10.1097/mcg.0000000000001962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND AND AIMS Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a potentially valuable tool for the diagnosis of pelvic lesions. The aim of this meta‑analysis was to evaluate the efficacy and feasibility of EUS-FNA in the diagnosis of pelvic lesions. METHODS We performed a computerized search of PubMed, EMBASE, Cochrane Library, and Science Citation Index, through March 2023. The main outcome measures examined in the meta-analysis were sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. RESULTS We evaluated 22 trials that used surgical pathology or imaging follow-up results as the reference standard. The studies comprised 844 patients. The cumulative sensitivity, specificity, PPV, NPV, and accuracy were 94%, 100%, 100%, 89%, and 96%, respectively. In the subgroup analysis, the prospective studies revealed the cumulative sensitivity, specificity, PPV, NPV, and accuracy were 91%, 100%, 100%, 85%, and 93%, respectively. CONCLUSIONS In conclusion, we provide evidence that EUS-FNA is a qualitative diagnostic technique with high sensitivity, specificity, PPV, and accuracy. However, its NPV is slightly low, which does not exclude the risk of a missed diagnosis, and more randomized controlled trials or prospective studies are still needed in the future. EUS-FNA is effective and feasible for pelvic space-occupying lesions. This technique has high clinical application value for pelvic lesions.
Collapse
Affiliation(s)
- Tong Su
- Departments of Gastroenterology
| | | | | | - Jing Wang
- Infectious Diseases, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | | | | | | |
Collapse
|
2
|
The role of rectal endoscopic ultrasonography plus fine needle aspirartion and fine needle biopsy in pelvic masses. Eur J Gastroenterol Hepatol 2023; 35:153-158. [PMID: 36574305 DOI: 10.1097/meg.0000000000002468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIM The diagnostic role of endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) and fine needle biopsy (FNB) of pelvic masses has not been well established. We aimed to evaluate the diagnostic accuracy of EUS plus FNA/FNB in suspected local recurrence of pelvic masses. MATERIALS AND METHODS All consecutive patients with a history of lower gastrointestinal and pelvic mass undergone EUS-FNA/FNB were included in the study. RESULTS In total 34 patients who underwent EUS-guided FNA or FNB of a perirectal mass were enrolled. The sampled lesion was a mass in 22 patients (64.7%) and a lymph node in 10 patients (29.4%). The univariate logistic regression analysis for diagnostic accuracy showed lesion size as a significant predictor of diagnostic accuracy [odds ratio (OR), 1.61; 1.08-2.27; P = 0.02]. Diagnostic sensitivity was 100% (71.5-100%) with EUS-FNB and 75% (34.9-96.8%) with EUS-FNA ( P = 0.12); specificity was 100% in both groups ( P = 1.0). Sample adequacy was 94.1% in the whole cohort, with 20/20 adequacy rate (100%) in the EUS-FNB group and 12/14 (85.7%) in the EUS-FNA group ( P = 0.28). CONCLUSION This is the first study demonstrating the diagnostic yield of EUS plus FNA/FNB in patients with pelvic masses comparing the two needles. Our results highlight the relevance of this technique, especially in undefined masses during oncological follow-up.
Collapse
|
3
|
Mazza S, Laurenza C, Elvo B, Tanzi G, Ungari M, Soro S, Verga MC, Drago A, Grassia R. Rectal linitis plastica as the first presentation of metastatic lobular breast cancer: an endoscopic ultrasound diagnosis. Clin J Gastroenterol 2022; 15:1072-1077. [DOI: 10.1007/s12328-022-01690-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/15/2022] [Indexed: 10/14/2022]
|
4
|
Khoury T, Sbeit W, Ludvik N, Nadella D, Wiles A, Marshall C, Kumar M, Shapira G, Schumann A, Mizrahi M. Concise review on the comparative efficacy of endoscopic ultrasound-guided fine-needle aspiration vs core biopsy in pancreatic masses, upper and lower gastrointestinal submucosal tumors. World J Gastrointest Endosc 2018; 10:267-273. [PMID: 30364716 PMCID: PMC6198315 DOI: 10.4253/wjge.v10.i10.267] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/02/2018] [Accepted: 07/23/2018] [Indexed: 02/06/2023] Open
Abstract
Endoscopic ultrasound (EUS)-guided fine needle aspiration with or without biopsy (FNA/FNB) are the primary diagnostic tools for gastrointestinal submucosal tumors. EUS-guided fine needle aspiration (EUS-FNA) is considered a first line diagnostic method for the characterization of pancreatic and upper gastrointestinal lesions, since it allows for the direct visualization of the collection of specimens for cytopathologic analysis. EUS-FNA is most effective and accurate when immediate cytologic assessment is permitted by the presence of a cytopathologist on site. Unfortunately, the accuracy and thus the diagnostic yield of collected specimens suffer without this immediate analysis. Recently, a EUS-FNB needle capable of obtaining core samples (fine needle biopsy, FNB) has been developed and has shown promising results. This new tool adds a new dimension to the diagnostic and therapeutic utility of this technique. The aim of the present review is to compare the efficacy of EUS-FNA to that afforded by EUS-FNB in the characterization of pancreatic masses and of upper and lower gastrointestinal submucosal tumors.
Collapse
Affiliation(s)
- Tawfik Khoury
- Department of Gastroenterology and Liver Unit, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Wisam Sbeit
- Institute of Gastroenterology and Liver Diseases, Galilee Medical Center Bar Ilan Faculty of Medicine, Naharia 22101, Israel
| | - Nicholas Ludvik
- Department of Internal Medicine, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, AL 251660, United States
| | - Divya Nadella
- Department of Internal Medicine, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, AL 251660, United States
| | - Alex Wiles
- Department of Internal Medicine, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, AL 251660, United States
| | - Caitlin Marshall
- Department of Internal Medicine, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, AL 251660, United States
| | - Manoj Kumar
- Department of Internal Medicine, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, AL 251660, United States
| | - Gilad Shapira
- Department of Internal Medicine, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, AL 251660, United States
| | - Alan Schumann
- Department of Internal Medicine, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, AL 251660, United States
| | - Meir Mizrahi
- Department of Internal Medicine, Division of Gastroenterology, Center for Advanced Endoscopy, University of South Alabama, Mobile, AL 251660, United States
| |
Collapse
|
5
|
McHugh KE, Sturgis CD, Procop GW, Rhoads DD. The cytopathology of Actinomyces, Nocardia, and their mimickers. Diagn Cytopathol 2017; 45:1105-1115. [PMID: 28888064 DOI: 10.1002/dc.23816] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 08/08/2017] [Accepted: 08/29/2017] [Indexed: 12/27/2022]
Abstract
Nocardia species and Actinomyces species are 2 of the most commonly diagnosed filamentous bacteria in routine cytopathology practice. These genera share many overlapping cytomorphologic features, including their thin, beaded, branching, Gram-positive, GMS-positive filamentous structures that fragment at their peripheries into bacillary- and coccoid-appearing forms. Features that help distinguish between these 2 microorganisms include the width of their filamentous structures, the angles at which they branch, and their ability or lack thereof to retain a modified acid-fast stain. In addition to cytomorphologic overlap, overlap in clinical presentation is frequent with pulmonary and mucocutaneous presentations seen in both. Differentiating between Nocardia and Actinomyces is essential because patients with these infections require different approaches to medical management. Both antibiotic susceptibilities and the need for early surgical intervention as part of the treatment plan vary greatly among these 2 groups. This review focuses on the clinical presentation, cytomorphology and staining characteristics that can be useful in identifying and distinguishing between Nocardia and Actinomyces infections, as well as their mimickers.
Collapse
Affiliation(s)
- Kelsey E McHugh
- Department of Laboratory Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio, 44195
| | - Charles D Sturgis
- Department of Laboratory Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio, 44195
| | - Gary W Procop
- Department of Laboratory Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio, 44195
| | - Daniel D Rhoads
- Department of Pathology, Case Western Reserve University, 10900 Euclid Ave, Cleveland, Ohio, 44106.,Department of Pathology, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, Ohio, 44106
| |
Collapse
|
6
|
Hassan GM, Paquin SC, Albadine R, Gariépy G, Soucy G, Nguyen BN, Sahai AV. Endoscopic ultrasound-guided FNA of pelvic lesions: A large single-center experience. Cancer Cytopathol 2016; 124:836-841. [PMID: 27448147 DOI: 10.1002/cncy.21756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 04/29/2016] [Accepted: 05/20/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Pelvic endoscopic ultrasound-guided fine-needle aspiration (PEUS-FNA) of rectal or perirectal lesions is safe, minimally invasive, and well tolerated. It provides valuable information, which can greatly influence patient management. Herein, the authors present what to their knowledge is the largest series to date of PEUS-FNA. METHODS PEUS-FNA specimens were retrieved from the archives of the study institution from January 2001 to March 2015. Only patients with solid pelvic lesions were examined. The cytopathology findings, immunohistochemistry, corresponding histology, and clinical data were collected. For analysis of accuracy, atypical or suspicious results were classified as "negative." The sensitivity and specificity of PEUS-FNA were calculated in a subset of patients with available surgical pathology. RESULTS A total of 127 cases meeting the current study criteria were obtained from patients who underwent PEUS-FNA at the study institution between January 2001 and March 2015. The mean age of the patients was 60 years, and 53% were female. Pelvic lesions were comprised of 72% masses and 28% lymph nodes, with a mean mass diameter of 27.38 mm (range, 5-100 mm). PEUS-FNA was positive for malignancy in 45% of cases, atypical/suspicious in 4.7% of cases, and negative for malignancy in 50.3% of cases. Surgical pathology was available for 44 patients. PEUS-FNA demonstrated 89.3% sensitivity, 100% specificity, a diagnostic accuracy of 93.2%, a positive predictive value of 100%, and a negative predictive value of 84.2%. No complications were noted. CONCLUSIONS PEUS-FNA is safe and effective for the investigation of pelvic lesions. Cancer Cytopathol 2016;124:836-41. © 2016 American Cancer Society.
Collapse
Affiliation(s)
- Galab M Hassan
- Department of Gastroenterology, Montreal University Medical Center, Montreal, Quebec, Canada
| | - Sarto C Paquin
- Department of Gastroenterology, Montreal University Medical Center, Montreal, Quebec, Canada
| | - Roula Albadine
- Department of Pathology, Montreal University Medical Center, Montreal, Quebec, Canada
| | - Gilles Gariépy
- Department of Pathology, Montreal University Medical Center, Montreal, Quebec, Canada
| | - Geneviève Soucy
- Department of Pathology, Montreal University Medical Center, Montreal, Quebec, Canada
| | - Bich N Nguyen
- Department of Pathology, Montreal University Medical Center, Montreal, Quebec, Canada
| | - Anand V Sahai
- Department of Gastroenterology, Montreal University Medical Center, Montreal, Quebec, Canada
| |
Collapse
|
7
|
Han C, Lin R, Liu J, Hou X, Qian W, Ding Z. Endoscopic Ultrasonography-Guided Biopsy for Differentiation of Benign and Malignant Pelvic Lesions: A Systematic Review and Meta-Analysis. Dig Dis Sci 2015; 60:3771-81. [PMID: 26341351 DOI: 10.1007/s10620-015-3831-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 07/29/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Preoperative diagnosis of pelvic lesions remains challenging despite advances in imaging technologies. Endoscopic ultrasonography (EUS)-guided biopsy is an effective diagnostic modality for sampling the digestive tract and surrounding areas. However, a meta-analysis summarizing the diagnostic efficacy of EUS-guided biopsy for pelvic lesions has not been published. AIMS We aimed to evaluate the utility of EUS-guided biopsy in the diagnosis of pelvic lesions. METHODS Articles were identified via structured database search; only studies where pelvic lesions were confirmed by surgery or clinical follow-up were included. Data extracted were selected with strict criteria. A fixed-effects model was used to estimate the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). A summary receiver operating characteristic curve (SROC) was also constructed. RESULTS Ten studies containing a total of 246 patients were included. The pooled sensitivity of EUS-guided biopsy for differential diagnosis of pelvic masses was 0.89 (95% CI 0.83-0.94), and the specificity was 0.93 (95% CI 0.86-0.97). The area under the SROC was 0.9631. The combined PLR, NLR, and DOR were 11.75 (95% CI 5.90-23.43), 0.12 (95% CI 0.07-0.20), and 100.06 (95% CI 37.48-267.10) respectively. There is potential presence of publication bias in this meta-analysis. CONCLUSIONS Our meta-analysis shows that EUS-guided biopsy is a powerful tool for differentiating pelvic masses with a high sensitivity and specificity. Furthermore, it is a safe procedure with low rate of complication, although more high-quality prospective studies are required to be done.
Collapse
Affiliation(s)
- Chaoqun Han
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Rong Lin
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Jun Liu
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Xiaohua Hou
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Wei Qian
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Zhen Ding
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| |
Collapse
|
8
|
Kim EY. Application of endoscopic ultrasonography in the diagnosis and treatment of lower gastrointestinal disease. Intest Res 2015; 13:101-2. [PMID: 25931992 PMCID: PMC4414749 DOI: 10.5217/ir.2015.13.2.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 03/31/2015] [Indexed: 12/13/2022] Open
Affiliation(s)
- Eun Young Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| |
Collapse
|
9
|
Soh JS, Lee HS, Lee S, Bae J, Lee HJ, Park SH, Yang DH, Kim KJ, Ye BD, Myung SJ, Yang SK, Kim JH, Byeon JS. The clinical usefulness of endoscopic ultrasound-guided fine needle aspiration and biopsy for rectal and perirectal lesions. Intest Res 2015; 13:135-44. [PMID: 25931998 PMCID: PMC4414755 DOI: 10.5217/ir.2015.13.2.135] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 11/17/2014] [Accepted: 12/09/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/AIMS Endoscopic ultrasound-guided fine needle aspiration and/or biopsy (EUS-FNA/B) have been used to diagnose subepithelial tumors (SETs) and extraluminal lesions in the gastrointestinal tract. Our group previously reported the usefulness of EUS-FNA/B for rectal and perirectal lesions. This study reports our expanded experience with EUS-FNA/B for rectal and perirectal lesions in terms of diagnostic accuracy and safety. We also included our new experience with EUS-FNB using the recently introduced ProCore needle. METHODS From April 2009 to March 2014, EUS-FNA/B for rectal and perirectal lesions was performed in 30 consecutive patients. We evaluated EUS-FNA/B performance by comparing histological diagnoses with final results. We also investigated factors affecting diagnostic accuracy. RESULTS Among 10 patients with SETs, EUS-FNA/B specimen results revealed a gastrointestinal stromal tumor in 4 patients and malignant lymphoma in 1 patient. The diagnostic accuracy of EUS-FNA/B was 50% for SETs (5/10). Among 20 patients with non-SET lesions, 8 patients were diagnosed with malignant disease and 7 were diagnosed with benign disease based on both EUS-FNA/B and the final results. The diagnostic accuracy of EUS-FNA/B for non-SET lesions was 75% (15/20). The size of lesions was the only factor related to diagnostic accuracy (P=0.027). Two complications of mild fever and asymptomatic pneumoperitoneum occurred after EUS-FNA/B. CONCLUSIONS The overall diagnostic accuracy of EUS-FNA/B for rectal and perirectal lesions was 67% (20/30). EUS-FNA/B is a clinically useful method for cytological and histological diagnoses of rectal and perirectal lesions.
Collapse
Affiliation(s)
- Jae Seung Soh
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho-Su Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seohyun Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jungho Bae
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyo Jeong Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Hoon Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Jo Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byong Duk Ye
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Jae Myung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin-Ho Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong-Sik Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
10
|
Cantamessa A, Brunocilla PR, Carucci P, Bruno M, Gaia S, Brizzi RF, Spandre M, Pacchioni D, Campione A, Rizzetto M, De Angelis C. Endoscopic ultrasound-guided fine needle aspiration in the diagnosis of pelvic metastasis of hepatocellular carcinoma: case report and review of literature. J Gastrointest Cancer 2013; 44:238-40. [PMID: 23054579 DOI: 10.1007/s12029-012-9440-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Alessandro Cantamessa
- Department of Gastro-Hepatology, San Giovanni Battista Hospital, University of Turin, Corso Bramante 88, 10126 Turin, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Amin K, Olyaee M, Tawfik O, Fan F. Endoscopic ultrasound-guided fine needle aspiration as a diagnostic and staging tool for rectal and perirectal lesions-an institutional experience. Ann Diagn Pathol 2013; 17:494-7. [PMID: 24028888 DOI: 10.1016/j.anndiagpath.2013.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 08/02/2013] [Indexed: 02/06/2023]
Abstract
The role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in evaluating lesions adjacent to the upper gastrointestinal tract wall is well established. However, this tool is underused in evaluating rectal and perirectal lesions, possibly due to insufficient experience and underrecognized value of this procedure. In this study, we report our institutional experience with EUS-FNA as a diagnostic and staging tool for rectal and perirectal lesions. A retrospective chart review was performed and a cohort of 38 patients who underwent rectal EUS-FNA (41 specimens) at our institution between January 2002 and July 2012 was retrieved. The cytology diagnoses were compared with the concurrent or follow-up histologic and clinical diagnoses. Among the total 41 cases, rectal EUS-FNA was performed as a diagnostic procedure in 22 (54%) and a staging procedure in 19 (46%) cases. On cytology examination, 18 cases (44%) were diagnosed as malignant; 1 (2%), as atypical/suspicious for malignancy; 3 (7%), as benign neoplastic; 13 (32%), as nonneoplastic; and 6 (15%), as nondiagnostic cases. Concurrent or follow-up histologic diagnoses were available in 20 cases (48%), 19 of them had concordant cytological/histologic findings (10 benign, 9 malignant). One perirectal lymph node with negative cytology diagnosis was found to be positive on histologic examination, probably due to sampling error on cytology. The sensitivity and specificity of EUS-FNA for detecting malignant rectal/perirectal lesions in this study were 91% and 100%, respectively. Endoscopic ultrasound-guided fine needle aspiration is a useful diagnostic tool for rectal/perirectal lesions; it confirms or excludes malignancy for lesions with high or low clinical suspicions. It serves as a reliable staging method to identify patients for proper clinical management.
Collapse
Affiliation(s)
- Khalid Amin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | | | | | | |
Collapse
|