Fine Needle Aspiration Biopsy of the Eye: A Single Institution's Experience.
Gillian Levy, Constantine Theoharis, David Chhieng, Miguel Materin, Guoping Cai. Yale University School of Medicine, New Haven, CT
Background: Typically, a microscopic diagnosis of tumor is required prior to treatment. Treatment decisions of intraocular lesions, however, are often based on clinical examination due to the difficulty and potential complications in performing ocular biopsies. Recently, fine needle aspiration (FNA) biopsy has been introduced as a diagnostic modality. The purpose of this study is to evaluate our experience with FNA biopsies of ocular lesions.
Design: The Department of Pathology database was queried and 26 cases of FNA biopsy of the eye were obtained from 2009-2010. The cytomorphologic features of aspirates were evaluated on cytospin or Thin Prep slides. Immunostains with melan A or flow cytometry were performed when indicated and additional material was available. The FNA diagnoses were classified into malignant (melanoma, lymphoma, metastatic tumor) or benign (reactive/inflammatory). The FNA diagnosis was compared with clinical and surgical follow ups that were available in 20 cases. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.
Results: Of the 26 cases obtained, there were 12 males and 14 females with ages ranging from 20 to 94 years. Eight cases were diagnosed as malignant or suspicious for malignancy (6 melanoma, 1 lymphoma, and 1 metastatic tumor) and 18 cases diagnosed as benign or atypical (3 atypical and 15 negative). Of the 20 cases with follow up there were 10 melanoma cases, 1 lymphoma case, and 9 benign cases. The correlation between the FNA diagnosis and follow up was shown in table 1.
|FNA Diagnosis||# of Cases||Benign Follow Up||Malignant Follow Up|