June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Fine Needle Aspiration for Suspected Uveal Metastases
Author Affiliations & Notes
  • claudine Bellerive
    Ocular Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Charles V. Biscotti
    Ocular Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Nakul Singh
    Case Western Reserve University, Cleveland, Ohio, United States
  • Arun D Singh
    Ocular Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   claudine Bellerive, None; Charles V. Biscotti, None; Nakul Singh, None; Arun Singh, Aura Biosciences (S), Castle Biosciences (C), Iconic Therapeutics (S), Isoaid Therapeutics (I), Risk calculator for vision loss following brachytherapy (P)
  • Footnotes
    Support  This study was supported in part by the NIH-NEI P30 Core Grant (IP30EY025585-01A1) and Unrestricted Grant from The Research to Prevent Blindness, Inc., awarded to the Cole Eye Institute.
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4403. doi:
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      claudine Bellerive, Charles V. Biscotti, Nakul Singh, Arun D Singh; Fine Needle Aspiration for Suspected Uveal Metastases. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4403.

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

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Abstract

Purpose : Fine needle aspiration (FNA) has widespread acceptance as a diagnostic test in the evaluation of intraocular masses, albeit indicated in only a small minority of cases. One such indication is the confirmation of a clinical suspicion of uveal metastasis. We analyzed our experience in this clinical setting to assess the effectiveness of FNA technique, which includes liquid-based cellular processing.

Methods : Twenty-eight consecutive patients presenting with suspected uveal metastasis were selected. The aspirates were performed using 25-gauge needle attached by tubing to a 5 ml syringe. Aspirate samples were visually inspected for adequacy, and then transferred to 30 ml CytoLyt® (Cytyc, Marlborough, MA). Subsequent ThinPrep® processing yielded at least one alcohol fixed Papanicolaou stained slide per case. Each aspirate sample was classified into the following categories: positive, atypical, negative or non-diagnostic. The "non-diagnostic" criterion was applied when atypical or malignant cells were not identified and yet there were insufficient cells for a "negative" interpretation (absence of metastasis). The electronic medical records provided all clinical data.

Results : The study group included 16 men and 12 women ranging from 27 to 85 years of age. Cytological interpretations were positive in 19 cases (68%), atypical in 2 cases (7%), negative in 4 cases (14%), and non-diagnostic in 3 cases (11%). The positive cases included 9 adenocarcinomas, 3 uveal lymphomas, 3 small cell carcinomas, 3 non-small cell carcinomas, and 1 metastatic paraganglioma. Both of the atypical cases were suspicious for non-Hodgkin lymphoma (NHL), including 1 vitreoretinal large cell NHL and 1 uveal low grade NHL. The 4 negative cases included 1 cryptococcosis, 1 inflammatory lesion that resolved spontaneously, and 2 inflammatory aspirates that subsequently proved to be metastatic adenocarcinoma. The 3 non-diagnostic cases included 1 schwannoma, 1 low grade uveal NHL and 1 metastatic adenocarcinoma. The overall sensitivity for FNA in cases of suspected uveal metastasis was 87.5%, with a specificity of 100%.

Conclusions : In our experience, FNA effectively confirms a clinical impression of uveal metastasis. Sixteen (84%) of 19 aspirates, from metastatic lesions, provided definitive diagnoses.

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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