Nair Lekha Krishnan, Sankar S
Department of Pathology, Government Medical College, Thiruvananthapuram, Kerala, India.
J Cytol. 2014 Apr;31(2):87-90. doi: 10.4103/0970-9371.138672.
Complexity in the anatomy of orbit and the fear of globe rupture are the main challenges faced in the diagnosis and typing of orbital masses. Fine needle aspiration cytology can be used as an initial investigative procedure in the evaluation of orbital masses, which in turn can aid the clinician to plan the treatment modalities. A close cooperation between ophthalmologist and pathologist adds to the success of the procedure.
The study was conducted in an attempt to evaluate the role of fine needle aspiration cytology (FNAC) in the diagnosis of orbital lesions as a cost-effective diagnostic technique, and to assess its diagnostic efficacy by comparing it with histopathological diagnosis.
The study was conducted on 50 patients, over a period of 3 years, who had presented with anterior orbital mass lesions with or without proptosis, and with those having accessible mass lesions. Patients with proptosis without anterior orbital masses, proptosis due to dysthyroid ophthalmopathy, arteriovenous fistulas, hamartomas and choristomas were excluded from the study. FNAC procedure was done after explaining about the procedure to the patient, and in the presence of an ophthalmologist.
Majority of patients belonged to the age group 50-59 years. Male: female ratio was 1.05: 1. The most common lesion on FNAC was non-Hodgkins lymphoma, [13 cases (31.7%)]. 11 (26.8%) cases out of this were confirmed to be non-Hodgkins lymphoma on histopathologic examination. Two cases turned out to be inflammatory pseudotumor.
FNAC can be done in all palpable orbital mass lesions with minimal risk and complications, with close cooperation between ophthalmologist and pathologist. A good degree of correlation was obtained between FNAC and histopathology, which was assessed by kappa statistics.
眼眶解剖结构的复杂性以及对眼球破裂的担忧是眼眶肿物诊断和分型面临的主要挑战。细针穿刺细胞学检查可作为评估眼眶肿物的初始检查方法，进而有助于临床医生规划治疗方式。眼科医生和病理学家之间的密切合作有助于该检查的成功。
本研究旨在评估细针穿刺细胞学检查（FNAC）作为一种经济有效的诊断技术在眼眶病变诊断中的作用，并通过与组织病理学诊断进行比较来评估其诊断效能。
本研究对50例患者进行了为期3年的观察，这些患者均有眼眶前部肿物病变，伴或不伴有眼球突出，且肿物易于触及。无眼眶前部肿物的眼球突出患者、甲状腺相关眼病、动静脉瘘、错构瘤和迷离瘤导致的眼球突出患者被排除在研究之外。在向患者解释操作过程并在眼科医生在场的情况下进行FNAC操作。
大多数患者年龄在50 - 59岁之间。男女比例为1.05 : 1。FNAC检查中最常见的病变是非霍奇金淋巴瘤，[13例（31.7%）]。其中11例（26.8%）经组织病理学检查确诊为非霍奇金淋巴瘤。2例为炎性假瘤。
在眼科医生和病理学家密切合作下，对所有可触及的眼眶肿物病变均可进行FNAC检查，风险和并发症最小。通过kappa统计评估，FNAC与组织病理学之间具有良好的相关性。
