June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Correlation between radiologic differential diagnosis and final histopathologic diagnosis in biopsy-proven adult orbital tumors
Author Affiliations & Notes
  • Alexander Knezevic
    Ophthalmology, Northwestern University, Chicago, Illinois, United States
  • Hans Barron Heymann
    Ophthalmology, Northwestern University, Chicago, Illinois, United States
  • John C Heymann
    Radiology, University of Texas Medical Branch, Galveston, Texas, United States
  • Paul Bryar
    Ophthalmology, Northwestern University, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Alexander Knezevic, None; Hans Heymann, None; John Heymann, None; Paul Bryar, None
  • Footnotes
    Support  Supported by an unrestricted grant from Research to Prevent Blindness Inc, New York, NY
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1788. doi:
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    • Get Citation

      Alexander Knezevic, Hans Barron Heymann, John C Heymann, Paul Bryar; Correlation between radiologic differential diagnosis and final histopathologic diagnosis in biopsy-proven adult orbital tumors. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1788.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The purpose of this study is to determine the frequency with which a radiologist includes the final histopathologic diagnosis in the radiologic differential diagnosis given for imaging studies used to evaluate adult orbital lesions.

Methods : A retrospective chart review was conducted using the Northwestern Enterprise Data Warehouse for all adult patients having undergone orbital biopsies from January 2000 to October 2014. 105 orbital biopsies (in 103 patients) with corresponding histopathologic diagnoses were identified. Of the 105 cases, 99 were evaluated preoperatively with either CT or MRI scan that was available for review.

Results : Of the 99 patients with imaging studies, 67 (67.7%) were CT scans, and 32 (32.3%) were MRI studies. Radiologists gave a radiographic differential diagnosis in 86 of 99 (86.9%) imaging studies performed. Of those in which a differential was given, the final histopathologic diagnosis was included in the radiographic differential diagnosis in 67 out of 86 cases (77.9%). A radiologic differential diagnosis was provided in 57 of 67 (85.1%) of CT scans and 29 of 32 (90.6%) of MRIs. The final histopathologic diagnosis was included in the radiologic differential in 24 of 29 (82.1%) MRIs and 43 of 57 (75.4%) of CTs. In 19 of 86 (20.1%) cases, a radiographic differential diagnosis was given, but it did not include the final histopathologic diagnosis. The five most common pathologic diagnoses not included in the initial radiographic differential were: extranodal marginal B cell lymphoma, amyloidosis, sarcoidosis, schwannoma, and solitary fibrous tumor. Of these lesions, the final diagnosis was not included in the radiographic differential diagnosis in 4 of 15 total extranodal marginal zone lymphomas (26.7%), 3 of 4 amyloidosis (75%), 2 of 5 sarcoidosis (40%), 2 of 3 schwannoma (67%), and 2 of 3 solitary fibrous tumors (67%).

Conclusions : Radiologists at a large urban academic center predict the final histopathologic diagnosis of adult orbital tumors requiring biopsy in 77.9% of cases. The majority of the final diagnoses that were not included on the radiographic differential diagnosis were lymphomatous, inflammatory, or infiltrative disorders.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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