Role of fine needle aspiration cytology in the diagnosis of orbital masses: A study of 41 cases

Abstract

Background:Complexity in the anatomy of orbit and the fear of globe rupture are the main challenges faced in the diagnosis and typing of orbital masses. Fine needle aspiration cytology can be used as an initial investigative procedure in the evaluation of orbital masses, which in turn can aid the clinician to plan the treatment modalities. A close cooperation between ophthalmologist and pathologist adds to the success of the procedure.Aim:The study was conducted in an attempt to evaluate the role of fine needle aspiration cytology (FNAC) in the diagnosis of orbital lesions as a cost-effective diagnostic technique, and to assess its diagnostic efficacy by comparing it with histopathological diagnosis.Materials and Methods:The study was conducted on 50 patients, over a period of 3 years, who had presented with anterior orbital mass lesions with or without proptosis, and with those having accessible mass lesions. Patients with proptosis without anterior orbital masses, proptosis due to dysthyroid ophthalmopathy, arteriovenous fistulas, hamartomas and choristomas were excluded from the study. FNAC procedure was done after explaining about the procedure to the patient, and in the presence of an ophthalmologist.Results:Majority of patients belonged to the age group 50-59 years. Male: female ratio was 1.05: 1. The most common lesion on FNAC was non-Hodgkins lymphoma, [13 cases (31.7%)]. 11 (26.8%) cases out of this were confirmed to be non-Hodgkins lymphoma on histopathologic examination. Two cases turned out to be inflammatory pseudotumor.Conclusions:FNAC can be done in all palpable orbital mass lesions with minimal risk and complications, with close cooperation between ophthalmologist and pathologist. A good degree of correlation was obtained between FNAC and histopathology, which was assessed by kappa statistics.

Fine needle aspiration cytology of orbital and ocular adnexal lesions

“…The authors investigated the role of FNAC in the diagnosis of palpable orbital and ocular adnexal masses and comparable to the most recent studies [1215] showed a concordance rate of 90% between the FNAC and histopathological results. [21] In their series, it was not indicated whether the size, location, and the radiologic appearance of the lesions in terms of being focal or diffuse might have any effect on the rate of insufficient aspirates or the diagnostic accuracy of FNAC.…”

“…Hence, validating FNAC as a harmless and effective diagnostic method needs a large-scale, randomized, prospective, and multicenter study. Nonetheless, the high success rates of FNAC of orbital and adnexal lesions in the series reported by Khan et al[21] and prior studies [11121415] are certainly of value to both orbital surgeons and patients. Via implementation of this safe technique, orbitotomies may be avoided in the lesions which can be managed with medical therapies, as in infectious, lympho-proliferative, and non-resectable lesions.…”

Automated tru-cut imaging-guided core needle biopsy of canine orbital neoplasia. A prospective feasibility study

“…While these methods provide sufficient histological tissue, they require high morbidity surgical intervention (Slatter and Abdelbaki, 1979;Gilger et al, 1994;Boston, 2010;Hakannsson and Hakannsson, 2010;Gelatt and Withley, 2011;Spiess and Pot, 2013). In contrast, fine needle aspiration biopsy is effective and sometimes may be acceptable in ocular oncology (Tani et al, 2006;Agrawi et al, 2013;Nair and Sankar, 2014). Imaging-guided core needle A.…”

Diagnostic Approaches to Metastatic Hepatocellular Carcinoma of the Orbit

“…[8][9][10] There is minimal disruption of surrounding tissues, and the cells retrieved are reliable for definitive pathological diagnosis 75% to 86% of the time. [6][7][8][9][10][11] Specific to hepatic pathology, FNAB has also played a role in liver biopsy and the distinction of HCC from benign liver masses. 12 Because of advances in immunohistochemistry, there are a variety of markers to determine the tissue of origin in the instance of metastasis.…”