The Role of Fine Needle Aspiration of Orbital Lesions: A Case Series

Acta Cytol. 2016;60(1):31-8. doi: 10.1159/000444385. Epub 2016 Mar 18.

Abstract

Objective: This paper analyzes a series of ultrasound (US)-guided orbital fine needle aspirations (FNAs) which provide diagnostic information that cytopathologists approaching orbital lesions for the first time can find useful and underlines the importance of teamwork.

Study design: The investigators retrospectively obtained data from 24 consecutive orbital FNAs. For all patients, a complete clinicoradiological database was created. FNAs were performed under US guidance with 25-gauge needles and an aspiration biopsy syringe gun, and sent to the Department of Pathology for examination and data management.

Results: The mean age of the patients was 54 years. Imaging studies included US, magnetic resonance imaging and computed tomography scans; 9 lesions involved the right orbit and 15 the left orbit. The mean lesion size was 23.6 ± 7.2 mm. After microscopic examination, 7 smears were labeled as 'nondiagnostic', while in 17 cases a definitive diagnosis was proposed, which always proved to be correct (70.8%, specificity = 100%).

Conclusions: The investigators believe that FNA biopsy of orbital masses is a necessary step; its weaknesses lie in the particularly delicate site of sampling and the extreme heterogeneity of lesions. Nevertheless, when orbital FNA is performed within a well-coordinated multidisciplinary team, it is a powerful tool that can be used to define the most appropriate management of these patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle / methods*
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Orbit / diagnostic imaging
  • Orbit / pathology*
  • Orbital Diseases / diagnostic imaging
  • Orbital Diseases / pathology*
  • Orbital Neoplasms / diagnostic imaging
  • Orbital Neoplasms / pathology*
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Ultrasonography
  • Young Adult