Transvitreal fine needle aspiration biopsy: The influence of intraocular lesion size on diagnostic biopsy result

Abstract

Transvitreal biopsy is a highly accurate diagnostic procedure with a low complication rate. It is a reliable diagnostic tool in suspicious choroidal lesions greater than 2 mm thick.

Prognostic implications of cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy

“…Several groups have reported the cytopathological classification of the tumor cells they obtained during FNAB (13,15,16,18) , and occasional groups have also reported cytopathological versus histopathological classification of tumors evaluated by FNAB and managed by enucleation and transcleral resection (10,15,17,22,35) . Although reported studies of cytopathological classification of tumor cells obtained by FNAB and histopathological classification of the entire tumor evaluated following enucleation show reasonably good agreement between these assignments (10,17,19,22,35) , many clinicians and ophthalmic pathologists remain skeptical about the reliability and prognostic value of melanoma pathological classification based on FNAB.…”

“…Although reported studies of cytopathological classification of tumor cells obtained by FNAB and histopathological classification of the entire tumor evaluated following enucleation show reasonably good agreement between these assignments (10,17,19,22,35) , many clinicians and ophthalmic pathologists remain skeptical about the reliability and prognostic value of melanoma pathological classification based on FNAB. This skepticism seems to stem from concern about the potential for FNAB to yield non-representative tumor specimens, recognition that cytology provides only cellular features and not tissue features of the tumors (which are important for histopathological classification), and realization that there is considerable variability in histopathological classification of uveal melanomas by ophthalmic pathologists who analyze the same microslides of selected tumors (43,44) .…”

“…Over the years, various authors have described and illustrated the cytomorphological and immunocytochemical features of melanocytic uveal tumor cells obtained by FNAB (1,13,(15)(16)(17)(18)(19)(20)(21) and the relative frequencies of spindle, epithelioid, mixed and necrotic tumor cells in the obtained specimens (13,15,17) . A few groups of investigators have described the correlation between cytopathological and histopathological classification of the uveal me lanoma cells in cases treated by enucleation or transcleral tumor resection, (4,10,15,17,22) and some investigators have also reported the frequency of insufficient aspirates for cytopathological diagnosis in their series and factors associated with this result (3,8,10,(21)(22)(23)(24)(25)(26)(27) . .…”

Ocular metastases

“…This particularly is a concern for tumours o2 mm in thickness. 9 All techniques carry a risk of intraocular haemorrhage and hence visual loss, which is why I prefer to determine the diagnosis by my noninvasive methods first.…”

Fine needle aspiration biopsy to reestablish cell culture in an animal model of uveal melanoma

“…Interestingly, the fundus examination of the only animal from which FNAB did not establish a cell culture, revealed an extensive retinal detachment overlying a diffuse choroidal thickening but no solid, elevated mass was detected. The fact that it is difficult to yield sufficient cells from small and rather flat choroidal melanomas has been reported in clinical studies (8,21) . Similarly, this limitation was also encountered in our animal model.…”