title: EUS-guided fine needle aspiration and trucut needle biopsy for examination of rectal and perirectal lesions.
abstract: OBJECTIVE
  Few studies have assessed the diagnostic efficacy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and/or trucut biopsy (TCB) in patients with rectal and perirectal lesions. We aimed to evaluate the diagnostic utility of EUS-FNA and/or TCB in patients with rectal and perirectal lesions. We also assessed their influence on the management and clinical course of these patients.
  
  
  METHODS
  We performed EUS-FNA and/or TCB in 11 consecutive patients (4 men and 7 women, 33-69 years) with rectal and perirectal lesions for whom conventional diagnostic tools could not provide definitive diagnoses. Patients with definite intraluminal cancer were excluded.
  
  
  RESULTS
  The 11 patients underwent 12 procedures, with 9 being EUS-FNA alone and 3 being EUS-FNA and TCB. Seven patients had rectal lesions and four had perirectal lesions. Initial EUS-FNA and/or TCB established a diagnosis of malignancy in five patients and of benign lesions in four. EUS-FNA plus TCB confirmed malignant lymphoma after diagnostic failure of initial EUS-FNA in one patient. In one other patient with suspicious secondary linitis plastica, EUS-FNA could not establish a definitive diagnosis. Correct diagnoses were obtained in 10 out of 11 patients who underwent EUS-FNA and/or TCB. EUS-FNA and/or TCB changed clinical courses, which included avoidance of unnecessary surgeries, having a chance of anal sphincter-saving surgeries, and timely administration of chemotherapy. No serious complications related to the use of EUS-FNA or TCB were evident.
  
  
  CONCLUSIONS
  EUS-FNA and/or TCB are useful in the diagnostic evaluation of and appropriate therapeutic plan in patients with rectal and perirectal lesions.
authors.affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
authors.forename: Sun-Jin
authors.initials: SJ
authors.lastname: Boo
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
authors.forename: Do Hyun
authors.initials: DH
authors.lastname: Park
authors.forename: Dong Wan
authors.initials: DW
authors.lastname: Seo
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Yang
authors.forename: Kee Wook
authors.initials: KW
authors.lastname: Jung
authors.forename: Kyung-Jo
authors.initials: KJ
authors.lastname: Kim
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Ye
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000196:Actinomycosis / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D044963:Biopsy, Fine-Needle; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008039:Linitis Plastica / Q000000981:diagnostic imaging / Q000556:secondary*; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology*; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000556:secondary; D013274:Stomach Neoplasms / Q000473:pathology*; D018084:Ultrasonography, Interventional