Pelvic inflammatory mass associated with sodium polystyrene sulfonate crystals diagnosed by endoscopic ultrasound‐guided fine needle aspiration cytology

Abstract

Surgical pathologists, especially those with subspecialty expertise in gastroenterological pathology, are by now relatively familiar with sodium polystyrene sulfonate (SPS) (Kayexalate, Concordia International Corp, Oakville, Ontario, Canada)-associated gastrointestinal tract injury. 1 In surgical pathology specimens, SPS typically presents as crystalline structures with a fish scale (FS) appearance. 2 To the best of our knowledge, the cytological morphology of SPS has not been previously described and there have been no previous reports of its diagnosis by fine needle aspiration (FNA). We report a case of a pelvic inflammatory mass associated with SPS diagnosed by endoscopic ultrasound-guided FNA (EUS-FNA). 2 | CASE PRESENTATION A 55 year old male developed a presumed bowel perforation following treatment with the cation-exchange resin SPS more than a decade ago. He presented to another facility several years later with a pelvic mass. Endoscopic ultrasound-guided fine needle core biopsy was performed and reported to be benign. Follow-up magnetic resonance

Transrectal endoscopic ultrasound-guided fine-needle aspiration biopsy for qualitative diagnosis of pelvic space-occupying lesions: a diagnostic test

“…All of the above-mentioned studies show the high diagnostic value of EUS-FNA for pelvic metastases. Another study reported the diagnosis of a sodium polystyrene sulfonate crystal-induced pelvic inflammatory mass using EUS-FNA ( 22 ). In the present study, EUS-FNA diagnosed 2 females with pelvic inflammatory masses, both of whom were asymptomatic.…”