Fine-Needle Aspiration Biopsy in Orbital Lesions: A Retrospective Study of 225 Cases

Am J Ophthalmol. 2016 Jun:166:37-42. doi: 10.1016/j.ajo.2016.03.021. Epub 2016 Mar 23.

Abstract

Purpose: To describe and analyze results from the fine-needle aspiration biopsy (FNAB) technique, used as a diagnostic tool, in patients with orbital lesions.

Design: Retrospective case series.

Methods: setting: Institutional (Karolinska Hospital, Stockholm).

Study population: 207 patients with 210 orbital lesions.

Intervention: 225 FNABs of the orbit.

Main outcome measures: Successful diagnosis from FNAB.

Results: Of the 210 orbital lesions evaluated with FNAB, a successful cytologic diagnosis was achieved in 176 (84%). In more than half of the orbital lesions (54%), the FNAB diagnosis in addition to imaging appearance, clinical appearance, and clinical history provided sufficient information for treatment, and the patient did not require an incisional or excisional biopsy. Ninety-seven patients underwent additional excisional or incisional biopsy; FNAB diagnoses and the histopathologic diagnoses corresponded in 87% of the cases with an intraclass correlation coefficient of 0.84 (95% confidence interval [CI] 0.76-0.90). The difference was statistically significant between the ability to make a successful cytologic FNAB diagnosis in palpable lesions vs nonpalpable lesions (successful diagnosis in 90% [CI = 85%-95%] vs 75% [CI = 66%-84%]; P < .01). Neither the orbital quadrant location, nor the radiologic appearance (diffuse vs encapsulated), nor size of the lesion affected the success of FNAB diagnoses (all P > .7). There was a complication in 6 cases (3%). All complications were temporary and none led to permanent damage.

Conclusions: FNAB proved effective and exceedingly safe. With the current healthcare climate of minimally invasive surgery and cost control, FNAB should be considered as a valid alternative to open surgery in the evaluation and management of orbital lesions.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Fine-Needle*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Orbit / pathology*
  • Orbital Neoplasms / classification
  • Orbital Neoplasms / diagnosis*
  • Orbital Neoplasms / surgery
  • Retrospective Studies