Abstract
Purpose :
Evaluate whether FNAB of clinically diagnosed primary uveal melanomas (PUM) using 27 g biopsy needles yields aspirates that are similar to those obtained by FNAB using 25 g biopsy needles for cytopathological classification of the tumor.
Methods :
IRB-approved clinical investigation of FNABs of 32 consecutive patients with PUM in which needles of different gauges (25 and 27) were used to sample distinct tumor sites. Each tumor was sampled at 3 adjacent sites. The first site was sampled with a 27 g needle, and the aspirate obtained in this sampling was submitted for gene expression profile testing. The second and third sites were sampled consecutively with a 27 g and 25 g needles, but these aspirates were submitted for cytology. The principal endpoints evaluated were sufficiency of the aspirates obtained using the different caliber needles and melanoma cytopathology in the two aspirates.
Results :
The 32 studied patients ranged in age from 28 - 87 years (mean= 65.2 yr). Eightee patients were women. Seventeen tumors were exclusively choroidal, 6 ciliochoroidal, 7 iridociliochoroidal, and 2 were exclusively iridic. Tumors ranged in size from 3.3 mm to 23 mm in largest basal diameter (mean LBD 13.2 mm) and from 0.5 mm to 12 mm in maximal thickness (mean thickness 6.4 mm). The aspirates obtained using the different caliber needles were sufficient for cytopathological diagnosis and classification in 31 of the 32 cases (96.9%). The single case that yielded an insufficient aspirate for cytopathological diagnosis using 27 g and 25 g needles. Cytopathological classification was identical in the two aspirates in all 31 cases that yielded sufficient aspirates. The obtained melanocytic tumor cells were classified as spindle melanoma cells in 14, mixed spindle and epithelioid melanoma cells in 14, epithelioid melanoma cells in 1, and nevus cells in 2. The only difference between the 25 g and 27 g aspirates was a greater amount of blood and fibrinous debris in the 25 g cases.
Conclusions :
FNAB aspirates obtained using 27 g biopsy needles appear sufficient for cytopathological and GEP classifications of PUM in the vast majority of cases. 25 g needles appear to cause more bleeding but generally do not increase the yield of tumor cells.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.