Endorectal Ultrasound-Guided Fine-Needle Aspiration: A Useful Diagnostic Tool for Perirectal and Intraluminal Lesions

Abstract

Objectives: Endorectal endoscopic ultrasound (ERUS) allows highly detailed assessment of the rectal wall layers and visualization of the extraluminal structures. Herein, we study the utility of ERUS fine-needle aspiration (FNA) to evaluate perirectal lesions. Study Design: Forty-nine ERUS-FNAs were retrieved from the cytopathology archives of The Johns Hopkins Hospital. The cytology slides, corresponding histology, immunohistochemistry when available, and clinical data were reviewed. Results: The aspirated material showed malignant (n = 24), benign (n = 19), atypical (n = 3), carcinoid tumor (n = 1), and nondiagnostic conditions (n = 2). The past medical history of 36 cases was significant for carcinomas. The primary site of the tumors included colorectal, urinary bladder, prostate, pancreas, gallbladder, ovary, and female lower genital tract. Statistical analysis for endoscopic ultrasonography FNA showed 87% sensitivity, 100% specificity, diagnostic accuracy of 90%, and a positive predictive value of 100% and a negative predictive value of 77%. Conclusion: ERUS-FNA can be utilized for: (1) accurate staging of colorectal adenocarcinomas by evaluation of nodal metastasis, depth of transmural tumor invasion and local tumor spread to perirectal fat, (2) prevention of aggressive surgical intervention in benign conditions, (3) providing diagnostic material for ancillary studies, and (4) evaluation of perirectal lesions with a more accurate method by combining imaging and histology.

Endoscopic ultrasound‐guided FNA of pelvic lesions: A large single‐center experience

“…The results of the current study are consistent with the previous smaller series regarding the diagnostic accuracy and safety of PEUS-FNA. [1][2][3][8][9][10][11][12][13] ROSE was performed in nearly all cases. The results of the current study support the usefulness of ROSE in terms of increasing the diagnostic yield by limiting the number of passes and decreasing the number of inadequate samples.…”

Endoscopic Ultrasound-Guided Fine Needle Aspiration Is Highly Accurate for the Diagnosis of Perirectal Recurrence of Colorectal Cancer

“…6 Boo et al 15 performed eus fna or eus-trucut biopsy in 4 patients with perirectal lesions and were able to obtain cytology or tissue for diagnosis in all of them. finally, maleki et al 16 described the usefulness of eus fna in the diagnosis of perirectal lesions. in this series, only 9 patients with a history of CRC were included, and in all of them the cytology confirmed the recurrence of the tumor.…”

Endoscopic ultrasound in oncology: An update of clinical applications in the gastrointestinal tract

“…EUS-FNA has a sensitivity, specificity, PPV and NPV of 89%, 79%, 89% and 79% respectively[97,101]. The fact that EUS-FNA has a moderate NPV (77%) for N staging means that LN metastases cannot be ruled out by a negative FNA[102]. Even though most perirectal nodes detected by EUS in patients with RC are metastatic, it is important to confirm this.…”