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Fine-needle aspiration biopsy for suspected uveal metastases

      Abstract

      Objective

      One indication of fine-needle aspiration biopsy (FNAB) is the diagnostic confirmatory of a clinical suspicion of uveal metastasis. We analyzed our experience in this clinical setting to assess the effectiveness of FNAB technique.

      Design

      Retrospective study.

      Participants

      28 patients (28 eyes) underwent FNAB biopsy.

      Methods

      Aspirates were performed using 25-gauge needle and were classified into the following categories: positive, atypical, negative, or nondiagnostic. The electronic medical records provided all clinical data. Subsequent clinical course was considered as the diagnostic standard.

      Results

      Subsequent clinical course was metastatic tumour in 19 cases (68%) and nonmetastatic tumour in other 9 cases, considered as the diagnostic standard. Cytological interpretations for metastases were positive in 19 cases (68%), atypical in 2 cases (7%), negative in 4 cases (14%), and nondiagnostic in 3 cases (11%). The metastasis-positive cases included 9 adenocarcinoma, 3 uveal lymphoma, 3 small cell carcinomas, 3 non–small cell carcinomas, and 1 metastatic paraganglioma. Both of the atypical cases were suggestive for non-Hodgkin lymphoma. The 4 negative cases for metastases included 2 true negative cases, and 2 false negative aspirates that subsequently proved to be metastatic adenocarcinoma. The 3 nondiagnostic cases included 1 schwannoma, 1 low-grade uveal non-Hodgkin lymphoma, and 1 metastatic adenocarcinoma. The overall sensitivity for FNAB was 87.5%, with a specificity of 100%.

      Conclusions

      FNAB of suspected uveal metastases is a reliable diagnostic technique.

      Résumé

      Objectif

      Évaluer l'efficacité de la biopsie à l'aiguille fine (BAF) pour confirmer le diagnostic clinique de métastase uvéale.

      Méthodes

      Vingt-huit spécimens (28 yeux) ont été obtenus à l'aide d'une aiguille de calibre 25 et ont été répartis en quatre catégories: positif, atypique, négatif ou non-diagnostique. Les données cliniques ont été révisées de manière rétrospective dans les dossiers médicaux électroniques. Le suivi clinique du patient était considéré comme le standard diagnostique.

      Résultats

      Le diagnostic de métastase uvéale a été confirmé dans 19 cas (68%) et infirmé dans les 9 autres cas. L'interprétation cytologique était positive dans 19 cas (68%), atypique dans 2 cas (7%), négative dans 4 cas (14%) et non-diagnostique dans 3 cas (11%). Parmi les 19 cas positifs, 16 (84%) ont été démontrés comme des vrai positifs, dont 9 adénocarcinomes, 3 carcinomes à petites cellules, 3 carcinomes non à petites cellules et 1 paragangliome para-aortique de la région iliaque. Les 2 cas atypiques se sont avérés être des lymphomes non-Hodgkinien. Parmi les 4 cas négatifs, il y avait 2 vrai négatifs et 2 faux négatifs, qui incluaient des adénocarcinomes métastatiques. Les 3 cas non-diagnostiques incluaient 1 schwannome, 1 lymphome uvéal de bas-grade et un adénocarcinome métastatique. La sensibilité de la BAF était de 87.5%, avec une spécificité de 100%.

      Conclusions

      La BAF est une technique diagnostique efficace dans les cas des métastases uvéales.
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