Utility of EUS-guided biopsy of extramural pelvic masses.
Gastrointest Endosc
; 75(1): 146-51, 2012 Jan.
Article
in En
| MEDLINE
| ID: mdl-22018550
ABSTRACT
BACKGROUND:
The diagnostic utility of EUS-guided FNA (EUS-FNA) and EUS-guided Trucut biopsy (EUS-TCB) of pelvic masses has not been well described.OBJECTIVE:
To evaluate the utility of EUS in the diagnosis of pelvic masses.DESIGN:
Retrospective cohort study.SETTING:
Single tertiary referral hospital in Indianapolis, Indiana. PATIENTS Consecutive patients referred for EUS evaluation of pelvic mass from January 2002 to July 2009. Patients with newly diagnosed rectal cancer or a known/suspected intramural mass were excluded.INTERVENTIONS:
EUS-FNA and/or EUS-TCB. MAIN OUTCOME MEASUREMENTS Endosonographic features and cytological and pathological findings were evaluated. The final diagnosis was confirmed by surgical pathology or cytology and clinical follow-up. The sensitivities and specificities of EUS-TCB were calculated in a subset of patients with available surgical pathology.RESULTS:
A total of 69 patients were identified, and 40 with intramural lesions (n = 36) or incomplete follow-up (n = 4) were excluded. The remaining 29 patients (15 men, mean age 58.5 ± 10.8 years) with pelvic masses (mean size 40.8 ± 20.1 mm) were evaluated. EUS-FNA or EUS-TCB helped to make the diagnosis in 25 of 29 patients (86%). Compared with surgical pathology (available in 17 patients), EUS-FNA had a sensitivity of 88% (95% CI, 53%-98%) and specificity of 100% (95% CI, 65%-100%) for malignancy. EUS-TCB alone had a sensitivity of 67% (95% CI, 21%-94%) and specificity of 100% (95% CI, 34%-100%) for malignancy, but the combination of EUS-FNA and EUS-TCB had a sensitivity of 100% (95% CI, 68%-100%) and a specificity of 100% (95% CI, 68%-100%). Complications after EUS-FNA included a pelvic abscess in 2 patients (7%) with a cystic pelvic mass.LIMITATION:
Single-center study.CONCLUSION:
EUS-FNA and EUS-TCB are sensitive for the diagnosis of malignancy in pelvic masses. Sampling of cystic masses in this region is discouraged.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pelvic Neoplasms
/
Ultrasonography, Interventional
/
Endosonography
/
Biopsy, Fine-Needle
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Gastrointest Endosc
Year:
2012
Document type:
Article
Affiliation country:
United States
Publication country:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
/
US
/
USA