Fine-needle aspiration biopsy for suspected uveal metastases

Can J Ophthalmol. 2019 Dec;54(6):694-698. doi: 10.1016/j.jcjo.2019.03.016. Epub 2019 May 31.


Objective: One indication of fine-needle aspiration biopsy (FNAB) is the diagnostic confirmatory of a clinical suspicion of uveal metastasis. We analyzed our experience in this clinical setting to assess the effectiveness of FNAB technique.

Design: Retrospective study.

Participants: 28 patients (28 eyes) underwent FNAB biopsy.

Methods: Aspirates were performed using 25-gauge needle and were classified into the following categories: positive, atypical, negative, or nondiagnostic. The electronic medical records provided all clinical data. Subsequent clinical course was considered as the diagnostic standard.

Results: Subsequent clinical course was metastatic tumour in 19 cases (68%) and nonmetastatic tumour in other 9 cases, considered as the diagnostic standard. Cytological interpretations for metastases were positive in 19 cases (68%), atypical in 2 cases (7%), negative in 4 cases (14%), and nondiagnostic in 3 cases (11%). The metastasis-positive cases included 9 adenocarcinoma, 3 uveal lymphoma, 3 small cell carcinomas, 3 non-small cell carcinomas, and 1 metastatic paraganglioma. Both of the atypical cases were suggestive for non-Hodgkin lymphoma. The 4 negative cases for metastases included 2 true negative cases, and 2 false negative aspirates that subsequently proved to be metastatic adenocarcinoma. The 3 nondiagnostic cases included 1 schwannoma, 1 low-grade uveal non-Hodgkin lymphoma, and 1 metastatic adenocarcinoma. The overall sensitivity for FNAB was 87.5%, with a specificity of 100%.

Conclusions: FNAB of suspected uveal metastases is a reliable diagnostic technique.

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / secondary
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Fine-Needle*
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / secondary
  • Carcinoma, Small Cell / diagnosis*
  • Carcinoma, Small Cell / secondary
  • False Positive Reactions
  • Female
  • Humans
  • Lymphatic Metastasis
  • Lymphoma / diagnosis*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity
  • Uveal Neoplasms / diagnosis*
  • Uveal Neoplasms / secondary