Use of Fine Needle Cytology in the Diagnosis of Orbital and Eyelid Mass Lesions

OBJECTIVE To study the use offine needle cytology (FNC) in the diagnosis of orbital and eyelid lesions. STUDY DESIGN A total of 34 orbital and eyelid lesions were subjected to fine needle aspiration (FNA) and nonaspiration techniques, and the cytologic findings and diagnoses of 28 lesions were correlated histpathologically. Data were statistically analyzed, and the specificity, sensitivity, predictive values and rate of nondiagnostic aspirates were calculated. RESULTS Of 28 cases, 9 were orbital and 19 were eyelid lesions. There was 100% concordance in differentiating benign vs. malignant orbital and eyelid lesions; the concordance with respect to the precise histologic diagnosis was 100% for orbital and 77.7% for eyelid lesions. The overall percentage of malignant lesions was 53.1%; the rest were benign neoplastic, cystic or inflammatory lesions. The overall concordance rate in differentiating benign vs. malignant lesions and for precise histologic diagnosis was 100% and 80.8%, respectively. The rate of nondiagnostic aspirates was 5.9%. Sensitivity, specificity and positive and negative predictive values of FNA in detecting malignant lesions were 100%. CONCLUSION If done with adequate safety precautions to protect the eye, FNC is a simple, safe, reliable, minimally invasive and rapid test for diagnosis of orbital and eyelid lesions.

[1]  R. Srinivasan,et al.  Benign Skin Adenexal Tumor vs. Hemangioma: Diagnostic Pitfall Due to Cytologic Sampling Error , 2008, Acta Cytologica.

[2]  D. Basu,et al.  Fine Needle Aspiration Cytology of Primary Lymphoid Lesions of the Orbit , 2007, Acta Cytologica.

[3]  M. Pérez‐Guillermo,et al.  Fine‐needle aspiration of apocrine hidrocystoma—A potential mimic of papillary neoplasms metastasizing to the skin , 2004, Diagnostic cytopathology.

[4]  Ming-hua Zhu,et al.  [Fine needle aspiration cytology of eyelid sebaceous gland carcinoma and its differential diagnosis]. , 2004, Zhonghua bing li xue za zhi = Chinese journal of pathology.

[5]  R. Stern,et al.  Cytomorphologic Features of Sebaceous Carcinoma on Fine Needle Aspiration , 2000, Acta Cytologica.

[6]  N. Khandelwal,et al.  Orbital mass lesions: US-guided fine-needle aspiration biopsy--experience in 37 patients. , 1999, Radiology.

[7]  S. Saw,et al.  Incidence of eyelid cancers in Singapore from 1968 to 1995 , 1999, The British journal of ophthalmology.

[8]  F. Fulciniti,et al.  Fine needle aspiration (FNA) biopsy of orbital masses: a critical review of 51 cases , 1997, Cytopathology : official journal of the British Society for Clinical Cytology.

[9]  V. Maheshwari,et al.  Tumours of eyelid: a clinicopathologic study. , 1996, Journal of the Indian Medical Association.

[10]  J. Cangiarella,et al.  Fine needle aspiration cytology of orbital masses. , 1996, Acta cytologica.

[11]  D. Das,et al.  Orbital lesions. Diagnosis by fine needle aspiration cytology. , 1994, Acta cytologica.

[12]  D. Char,et al.  Orbital Pseudotumor: Fine-needle Aspiration Biopsy and Response to Therapy , 1993 .

[13]  C. Margo,et al.  Basal cell carcinoma of the eyelid and periocular skin. , 1993, Survey of ophthalmology.

[14]  R. Rewari,et al.  Fine needle aspiration cytology of orbital and adnexal masses. , 1992, Acta cytologica.

[15]  N. Fenske,et al.  Basal cell, squamous cell, and sebaceous gland carcinomas of the periorbital region. , 1991, Journal of the American Academy of Dermatology.

[16]  R. Rewari,et al.  Fine needle aspiration cytology of eyelid tumors. , 1990, Acta cytologica.

[17]  P. Vielh,et al.  Fine-needle cytology of 292 palpable orbital and eyelid tumors. , 1990, American journal of clinical pathology.

[18]  P. Becker,et al.  Fine needle cytology--is aspiration suction necessary? A study of 100 masses in various sites. , 1989, Acta cytologica.

[19]  D. Knowles,et al.  An overview of ocular adnexal lymphoid tumors. , 1989, Transactions of the American Ophthalmological Society.

[20]  D. Liu,et al.  Complications of fine needle aspiration biopsy of the orbit. , 1985, Ophthalmology.

[21]  Tesluk Gc.  Eyelid lesions: incidence and comparison of benign and malignant lesions. , 1985 .

[22]  C. Leone,et al.  Treatment protocol for orbital inflammatory disease. , 1985, Ophthalmology.

[23]  B. Johnson,et al.  Orbital fine-needle aspiration biopsy. , 1985, American journal of ophthalmology.

[24]  F. Hu,et al.  [Fine needle aspiration biopsy of orbital tumors]. , 1985, Taiwan yi xue hui za zhi. Journal of the Formosan Medical Association.

[25]  G. C. Tesluk.  Eyelid lesions: incidence and comparison of benign and malignant lesions. , 1985, Annals of ophthalmology.

[26]  B. Czerniak,et al.  Diagnosis of orbital tumors by aspiration biopsy guided by computerized tomography , 1984, Cancer.

[27]  W. Green,et al.  Sebaceous gland carcinoma. Review of 40 cases. , 1984, Archives of ophthalmology.

[28]  E. Malberger,et al.  Fine-needle aspiration of orbital lesions. , 1983, Annals of ophthalmology.

[29]  F. Jakobiec,et al.  Aspiration cytodiagnosis of lid tumors. , 1979, Archives of ophthalmology.

[30]  B. Johnson,et al.  Fine-Needle Aspiration Biopsy: Its Use in Orbital Tumors , 1979 .

[31]  P. Agrawal,et al.  Orbital involvement in tuberculosis. , 1977, Indian journal of ophthalmology.

[32]  L. Zimmerman,et al.  Sebaceous Carcinoma of the Eyelid, Eyebrow, Caruncle, and Orbit , 1972, International ophthalmology clinics.