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N. Trichopoulos, J.J. Augsburger; Cytopathologic–Histopathologic Correlation of Solid Posterior Segment Intraocular Tumors Evaluated by Fine–Needle Aspiration Biopsy and Treated by Enucleation . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5399.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the cytopathologic findings in clinically diagnosed solid posterior segment intraocular tumors evaluated by fine–needle aspiration biopsy (FNAB) with the subsequent histopathologic findings in a series of cases managed by primary enucleation. Methods: Retrospective study of FNAB results in 157 patients with an unequivocal clinical diagnosis of a solid malignant posterior segment intraocular tumor who were treated by primary enucleation. Twenty–three of these patients underwent diagnostic pre–enucleation FNAB of the tumor at the request of the patient for pathologic confirmation of our clinical diagnosis prior to surgery (group 1). The other 134 patients had a post–enucleation FNAB performed for cyto–histopathologic correlation (group 2). The pre–biopsy clinical diagnosis was uveal melanoma in 21 patients and retinoblastoma in 2 patients in group 1 and uveal melanoma in 109 patients, retinoblastoma in 24 patients and medulloepithelioma in 1 patient in group 2. Results: FNAB yielded a sufficient aspirate for reliable cytodiagnosis in all 23 cases in group 1 and in 127 of the 134 cases (94.8%) in group 2. Six of the 7 tumors that yielded an insufficient aspirate for cytodiagnosis in group 2 were uveal melanomas and 1 was medulloepithelioma. The cytopathologic diagnosis in group 1 was uveal melanoma in 21 eyes and retinoblastoma in 2. Histopathologic study confirmed the cytopathologic diagnosis in 22 of these 23 cases (95.7%). One case diagnosed as an amelanotic spindle cell melanoma by cytopathology proved to be an isolated retinal astrocytoma by histopathology. The FNAB aspirate in this case was too scant to allow immunohistochemical staining that might have avoided this misdiagnosis. The cytopathologic diagnosis in group 2 was uveal melanoma in 102, retinoblastoma in 22, and other in 3. Histopathologic study confirmed the cytopathologic diagnosis in 125 of the 127 tumors (98.4%) that yielded a sufficient aspirate for cytodiagnosis Conclusions: Histopathologic study of the cases in this series confirmed the cytopathologic diagnosis in 147 of 157 cases (93.6%). Cytopathologic evaluation of FNAB–derived tumor aspirates provides a reliable and accurate diagnosis of most solid posterior segment tumors that are managed by enucleation.
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