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The Use of Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Investigation of Submucosal and Extrinsic Masses of the Colon and Rectum
Submitted 15 December 2003
Accepted after Revision 6 September 2004
03 February 2005 (online)
Background and Study Aim: Ensdoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been reported as a useful technique for histological diagnosis of submucosal or extrinsic gastrointestinal and pancreatic lesions. The aim of this study was to evaluate the use of EUS-FNA for the diagnosis of lesions either within or adjacent to the wall of the colon and rectum.
Patients and Methods: A total of 22 patients with a lesion within the wall of, or adjacent to, the colon or rectum underwent EUS-FNA. They were divided into two groups: patients who had previously had a malignancy (the ”previous +ve” group, n = 11), and patients who had not previously had a malignancy (the ”previous -ve” group, n = 11). In the four patients who had lesions located proximal to the sigmoid colon, EUS-FNA was performed using a guide wire and overtube. The success rates for adequate tissue sampling and for detecting malignant and benign masses by EUS-FNA were evaluated and the success rate for detection was compared with the success rate of EUS and computed tomography.
Results: Sufficient tissue for evaluation was obtained from 21 of the 22 patients (95.5 %). The overall rate of detection of malignant and benign masses was 95.5 % (21/22) for EUS-FNA and 81.8 % (18/22) for pre-EUS-FNA imaging investigations. Of the 11 patients in the previous +ve group, ten were diagnosed with recurrences of primary malignancies; of the 11 patients in the previous -ve group, four were diagnosed with primary malignancies and seven were diagnosed with benign lesions. There were no complications related to the EUS-FNA procedure.
Conclusions: EUS-FNA is a safe technique which is useful in the planning of treatment for patients who have a mass within the wall or adjacent to the wall of the entire length of the colon or rectum.
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Y. Niwa, M. D.
Division of Therapeutic Medicine, Department of Internal Medicine, Nagoya University Graduate School of Medicine
65 Tsuruma-cho · Showa-ku · Nagoya 466-8560 · Japan
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