Hamilton Eye Institute, University of Tennessee Health Sciences Center, 930 Madison Avenue, Suite 470, Room 483, Memphis, TN 38163, USA.
Br J Ophthalmol. 2010 Jan;94(1):128-30. doi: 10.1136/bjo.2009.158600. Epub 2009 Jul 23.
To assess the diagnostic value of the orbital fine needle aspiration biopsy (FNAB) with an in vitro technique, eliminating the sampling error.
Prospective, non-randomised, interventional case series.
Sixty-eight patients were studied prospectively in institutional clinical practices. Immediately after excision of orbital mass lesions, the removed tissue was stabilised under the hand of the surgeon and biopsied with a 23- or 25-gauge needle. The samples were processed for cytopathological examination with Cytospin. The excised specimens were then submitted for routine histological examination. The cytopathological diagnoses were compared with the final histopathological diagnoses.
Six out of 68 lesions were excluded and the remaining 62 cases were divided into four groups as primary malignant, primary benign, secondary malignant and inflammatory lesions, based on histopathological diagnoses. In 43 cases the cytopathological and histopathological diagnoses were the same, with a concordance rate of 69%. Among the malignant tumours, the cytopathological diagnoses correlated with the histopathological diagnoses in 14/14 and 17/27 cases of metastatic/secondary and primary orbital malignancies, respectively. Of 11 primary benign tumours, two cytopathological diagnoses correlated with histopathology. In inflammatory lesions, the cytopathological diagnoses were matched with the histopathological diagnoses in 10/10 biopsies.
Even when the sampling error is eliminated with an "in vitro FNAB" technique, the concordance rates between histopathological and cytopathological diagnoses varied considerably among different types of orbital mass lesions. FNAB diagnoses were most reliable in metastatic and secondary malignancies and inflammatory lesions, and least reliable in benign orbital neoplasms and cysts.
评估消除取样误差的眶部细针抽吸活检术（FNAB）的诊断价值。
前瞻性、非随机、干预性病例系列研究。
68 例患者在机构临床实践中进行前瞻性研究。眶部肿块切除后，立即由外科医生稳定切除组织并用 23 或 25 号针进行活检。使用 Cytospin 对样本进行细胞病理学检查。然后将切除的标本提交常规组织学检查。将细胞病理学诊断与最终组织病理学诊断进行比较。
68 个病变中有 6 个被排除，其余 62 个病变根据组织病理学诊断分为原发性恶性、原发性良性、继发性恶性和炎症性病变四组。在 43 例中，细胞病理学和组织病理学诊断相同，符合率为 69%。在恶性肿瘤中，转移性/继发性和原发性眼眶恶性肿瘤的细胞病理学诊断分别与组织病理学诊断一致 14/14 例和 17/27 例。11 例原发性良性肿瘤中，有 2 例细胞病理学诊断与组织病理学一致。在炎症性病变中，细胞病理学诊断与组织病理学诊断在 10/10 例活检中相匹配。
即使使用“体外 FNAB”技术消除了取样误差，组织病理学和细胞病理学诊断之间的一致性在不同类型的眶部肿块病变之间差异很大。FNAB 诊断在转移性和继发性恶性肿瘤和炎症性病变中最可靠，在良性眶部肿瘤和囊肿中最不可靠。
