title: The utility of lower endoscopic ultrasound-guided fine needle aspiration for the diagnosis of benign and malignant pelvic diseases.
abstract: BACKGROUND
  The utility of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the diagnosis of pelvic masses has been suggested but limited data are available in the literature regarding its diagnostic accuracy.
  
  
  OBJECTIVE
  To report our institutional experience with EUS-FNA for the diagnosis of a variety of pelvic diseases.
  
  
  METHODS
  Patients who were referred for the evaluation of pelvic lesions using lower EUS-FNA were included in this retrospective analysis if they had available surgical pathology (obtained after EUS) which was considered the gold standard against which the EUS-FNA findings would have been compared. The diagnostic accuracy of EUS-FNA for pelvic masses was analyzed and any early or late complications after the procedure were reported. A pelvic mass was defined in the study as any mass seen with an imaging modality in the pelvic area including those involving the colonic wall.
  
  
  RESULTS
  Twenty patients had EUS-FNA followed by surgery for whom FNA cytology and surgical pathology findings were available. EUS-FNA reached the correct diagnosis in 19 out of 20 patients, whereas for the missing 1 malignant lymph node wherein FNA revealed benign cytology, surgical specimen confirmed metastatic colon cancer. The sensitivity and specificity of EUS-FNA were 90% and 100%, respectively, with positive and negative predictive values of 100% and 90%, respectively. No early or late complications were encountered with this procedure for the sampling of cystic and noncystic masses.
  
  
  CONCLUSIONS
  EUS-FNA has excellent diagnostic accuracy for pelvic masses. It represents a safe procedure with excellent yield and thus may be used as a first line modality for the evaluation and diagnosis of pelvic masses within its reach.
authors.affiliation: Departments of *Internal Medicine, Division of Gastroenterology and Hepatology †Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS.
authors.forename: Fadi
authors.initials: F
authors.lastname: Rzouq
authors.forename: Jesica
authors.initials: J
authors.lastname: Brown
authors.forename: Fang
authors.initials: F
authors.lastname: Fan
authors.forename: Melissa
authors.initials: M
authors.lastname: Oropeza-Vail
authors.forename: Elena
authors.initials: E
authors.lastname: Sidorenko
authors.forename: Richard
authors.initials: R
authors.lastname: Gilroy
authors.forename: Tuba
authors.initials: T
authors.lastname: Esfandyari
authors.forename: John
authors.initials: J
authors.lastname: Bonino
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Olyaee
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000473:pathology; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000556:secondary*; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D003560:Cysts / Q000000981:diagnostic imaging / Q000473:pathology; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014571:Urologic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology