Diagnostic Value of Ultrasound-Guided Fine-Needle Aspiration for Pelvic Space-Occupying Lesions Via Rectal Endoscopic Ultrasound

Abstract

Background/Aims: The present study seeks to appraise the therapeutic outcomes of cystic lesion management and the diagnostic performance of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in characterizing pelvic space-occupying lesions.

Materials and Methods: EUS-FNA was performed transrectally on 83 patients with pelvic space-occupying lesions identified using ultrasonography, computed tomography, or magnetic resonance imaging (MRI) from January 2016 to December 2024. Tissue was obtained for pathological analysis and smear cytology using a 19 G or 22 G puncture needle. Cytological samples are collected, and drainage is executed for pelvic cystic lesions. In the presence of an abscess, metronidazole solution was routinely provided for irrigation. Postoperatively, additional clinical monitoring was performed on patients to assess their prognosis, including the evaluation of clinical symptoms and laboratory indicators during follow-up.

Results: After pathological and/or cytological evaluation of 83 patients, 67 instances of solid masses were identified, comprising 41 adenocarcinomas, 6 malignant mesenchymal tumors, 7 inflammatory masses, 3 lymphomas, 2 dermoid cysts, and 8 other cases. Sixteen instances of cystic masses were recorded, comprising 3 plasma cystadenomas, alongside 13 occurrences of perirectal abscesses, of which 11 patients with perirectal abscess were drained of pus and treated with metronidazole injection. The comparison of 19G and 22G puncture needles revealed no statistically significant variation in the percentage of punctures amenable to immunohistochemistry (P > .05). Thirteen patients with perirectal abscesses exhibited differing degrees of pain during EUS-FNA. Except for 1 patient who exhibited hematochezia attributable to a pelvic lesion in the prostate, none of the other patients encountered postoperative complications, including fever or hematochezia.

Conclusion: The EUS-FNA is a direct, secure, and minimally invasive method with therapeutic promise for clarifying the characteristics of pelvic space-occupying lesions.

Cite this article as: Fan X, Wang C, Wang W, Gao S. Diagnostic value of ultrasound guided fine-needle aspiration for pelvic space-occupying lesions via rectal endoscopic ultrasound. Turk J Gastroenterol. Published online January 26, 2026. doi:10.5152/tjg.2026.25487.