Related Experiment Video
Updated: Aug 17, 2026
Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
Published on: June 17, 2025
Fine needle aspiration biopsy with adjunct immunohistochemistry in intraocular tumor management
Beverly E Faulkner-Jones1, William J Foster, J William Harbour
1Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Insights
Fine needle aspiration biopsy (FNAB) is effective for diagnosing intraocular tumors. Adding immunohistochemistry (IHC) improves diagnostic accuracy and can alter patient management.
Area of Science:
- Ophthalmology
- Oncology
- Pathology
Background:
- Solid intraocular tumors require accurate diagnosis for effective management.
- Fine needle aspiration biopsy (FNAB) is a minimally invasive technique for tissue sampling.
Purpose of the Study:
- To evaluate the diagnostic effectiveness of FNAB for intraocular tumors.
- To determine the impact of immunohistochemistry (IHC) on FNAB accuracy and patient management.
Main Methods:
- Thirty-three adult patients with suspected intraocular tumors underwent FNAB.
- Cytologic and histologic diagnoses were correlated.
- Positive predictive value, sensitivity, and specificity of FNAB (with and without IHC) were calculated.
Main Results:
- FNAB demonstrated high positive predictive value (93-96%) for malignancy.
- Immunohistochemistry (IHC) improved specificity from 67% to 83% and confirmed diagnoses in 75% of cases.
- FNAB findings altered clinical management in 24% of patients, with IHC being essential in 9%.
Conclusions:
- FNAB is a safe and effective method for diagnosing intraocular tumors.
- Routine use of IHC enhances the diagnostic utility of FNAB and influences clinical decisions.
Objective:
To assess the effectiveness of fine needle aspiration biopsy (FNAB), with and without immunohistochemistry (IHC), in the management of solid intraocular tumors.
Study Design:
Thirty-three consecutive adults undergoing FNAB of suspected intraocular tumors were studied. Clinical, cytologic and histologic diagnoses were correlated. The positive predictive value, sensitivity and specificity of FNAB for detecting malignancy, the effect of lHC on the final cytologic diagnosis and the number of patients in whom clinical management was altered as a result of cytologic evaluation were determined.
Results:
The positive predictive value was 96% with and 93% without adjunct IHC. The sensitivity and specificity of FNAB for detecting malignancy were 96% and 83%, respectively, with IHC. Without IHC, the sensitivity was unaltered, but the specificity was 67%. IHC confirmed the morphologic diagnosis in 75% of cases, made a diagnosis in 12.5% and changed a malignant diagnosis from carcinoma to melanoma in 6% of cases. The planned management was changed by the FNAB findings in 24% of patients. In 3 patients (9%), IHC was essential for diagnosis and management. No patients exhibited local tumor dissemination or recurrence associated with the biopsy.
Conclusion:
FNAB is a safe, sensitive and specific method of establishing a tissue diagnosis in a subset of patients with solid intraocular tumors. The routine use of immunohistochemical stain ing increases the diagnostic utility of the technique and may change clinical management.
