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Fine-Needle Aspiration Biopsy in Orbital Lesions: A Retrospective Study of 225 Cases
Anna C H Wiktorin1, Eva M E Dafgård Kopp1, Edneia Tani2
1Department of Oculoplastic and Orbital Service, St Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden.
Purpose:
To describe and analyze results from the fine-needle aspiration biopsy (FNAB) technique, used as a diagnostic tool, in patients with orbital lesions.
Design:
Retrospective case series.
Methods:
setting: Institutional (Karolinska Hospital, Stockholm).
Study Population:
207 patients with 210 orbital lesions.
Intervention:
225 FNABs of the orbit.
Main Outcome Measures:
Successful diagnosis from FNAB.
Results:
Of the 210 orbital lesions evaluated with FNAB, a successful cytologic diagnosis was achieved in 176 (84%). In more than half of the orbital lesions (54%), the FNAB diagnosis in addition to imaging appearance, clinical appearance, and clinical history provided sufficient information for treatment, and the patient did not require an incisional or excisional biopsy. Ninety-seven patients underwent additional excisional or incisional biopsy; FNAB diagnoses and the histopathologic diagnoses corresponded in 87% of the cases with an intraclass correlation coefficient of 0.84 (95% confidence interval [CI] 0.76-0.90). The difference was statistically significant between the ability to make a successful cytologic FNAB diagnosis in palpable lesions vs nonpalpable lesions (successful diagnosis in 90% [CI = 85%-95%] vs 75% [CI = 66%-84%]; P < .01). Neither the orbital quadrant location, nor the radiologic appearance (diffuse vs encapsulated), nor size of the lesion affected the success of FNAB diagnoses (all P > .7). There was a complication in 6 cases (3%). All complications were temporary and none led to permanent damage.
Conclusions:
FNAB proved effective and exceedingly safe. With the current healthcare climate of minimally invasive surgery and cost control, FNAB should be considered as a valid alternative to open surgery in the evaluation and management of orbital lesions.
