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Nieraj Jain, Victor Elner, Hakan Demirci; Improved Specimen Handling for Optimizing Diagnostic Yield from Fine Needle Aspiration Biopsy of Uveal Tumors. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4214.
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© ARVO (1962-2015); The Authors (2016-present)
To describe and evaluate a novel strategy of tissue handling of transscleral fine needle aspiration biopsy (FNAB) specimens in unknown uveal tumors.
This is a retrospective series of consecutive patients undergoing FNAB of uveal tumors from September 2010 through November 2012. The diagnostic yield and adverse outcomes are documented, including large (in excess of 3 disc diameters in greatest linear dimension) or fovea-involving subretinal hemorrhage, rhegmatogenous retinal detachment, and orbital metastasis. Surgical technique involves FNAB via a pars plana approach under indirect ophthalmoscopy. Upon collection, the specimen is placed in a microcentifuge tube and immediate low speed centrifugation is performed.
FNAB samples of 10 patients were analyzed. Cytopathological diagnosis was established in 8 of 10 patients (80%). Of these, 6 were choroidal melanoma, 1 was metastatic adenocarcinoma from the lung, and 1 was peripheral exudative hemorrhagic chorioretinopathy. The two subjects with non-diagnostic FNAB were later found by incisional biopsy to have melanoma of the ciliary body.
This technique compares favorably with those in the literature, despite a high number of small tumors. Improved specimen handling involving the use of a microcentrifuge tube for specimen collection, immediate low speed centrifugation, and formation of a cellular pellet may improve the diagnostic yield of this procedure.
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