Diagnostic yield of endoscopic ultrasound guided fine-needle aspirations of rectal and perirectal lesions

Aims To evaluate indications and diagnostic yield of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) of rectal and perirectal lesions.

Methods Data from a prospectively collected database of rectal EUS-FNAs performed at our tertiary endoscopy center from January 2014 until September 2024 were retrospectively evaluated. Indications for the procedure, technical success, adverse events and diagnostic yield were investigated.

Results 27 patients (mean age: 56±3 years, 63% female) underwent rectal EUS-FNA during the 10-year study period. Indications included suspicion of endometriosis in 4, lymph node enlargement in 6, tumor recurrence in 13, and undetermined fluid collection in 5 cases. Mean lesion size was 24 mm. Sampling was performed with a 19 G FNA/FNB needle in 16 cases, and with a 22 G needle in 8 cases, needle type was not reported in 3 cases. Technical success was achieved in 26 cases (96%) with smears and tissue sampling obtained in 25 and 23 cases, respectively. EUS-FNA/FNB confirmed the diagnosis in 20 cases (74%): endometriosis was confirmed in 1 case (25%), lymph node metastasis in 4 cases (67%), tumor recurrence in 10 cases (77%), and differential diagnosis of perirectal fluid collections were determined in all 5 cases (100%). Abscess progression in one case was the only adverse event reported (3.7%).

Conclusions EUS-FNA/FNB may assist differential diagnosis of rectal and perirectal lesions by providing a safe sampling method of lesions that are often inaccessible for other modalities. It can be especially useful in confirming recurrence of malignancy.

Publication History

Article published online:
27 March 2025