Cytopathologic Diagnosis of Benign Lesions Simulating Choroidal Melanomas

Char, Devron H.; Miller, Theodore R.; Crawford, J. Brooks

doi:10.1016/s0002-9394(14)76216-6

Cited by 35 publications

(17 citation statements)

References 25 publications

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“…Although reported studies of cytopathological classification of tumor cells obtained by FNAB and histopathological classification of the entire tumor evaluated following enucleation show reasonably good agreement between these assignments (10,17,19,22,35) , many clinicians and ophthalmic pathologists remain skeptical about the reliability and prognostic value of melanoma pathological classification based on FNAB. This skepticism seems to stem from concern about the potential for FNAB to yield non-representative tumor specimens, recognition that cytology provides only cellular features and not tissue features of the tumors (which are important for histopathological classification), and realization that there is considerable variability in histopathological classification of uveal melanomas by ophthalmic pathologists who analyze the same microslides of selected tumors (43,44) .…”

Section: Discussionmentioning

confidence: 99%

“…In most of these early cases, the objective of the FNAB was to establish, confirm, or refute the clinical diagnosis of the evaluated intraocular tumor and direct baseline systemic evaluation of the patient, treatment of the primary intraocular tumor, and post-treatment follow-up (1,4,5,9,(13)(14)(15) . Over the years, various authors have described and illustrated the cytomorphological and immunocytochemical features of melanocytic uveal tumor cells obtained by FNAB (1,13,(15)(16)(17)(18)(19)(20)(21) and the relative frequencies of spindle, epithelioid, mixed and necrotic tumor cells in the obtained specimens (13,15,17) . A few groups of investigators have described the correlation between cytopathological and histopathological classification of the uveal me lanoma cells in cases treated by enucleation or transcleral tumor resection, (4,10,15,17,22) and some investigators have also reported the frequency of insufficient aspirates for cytopathological diagnosis in their series and factors associated with this result (3,8,10,(21)(22)(23)(24)(25)(26)(27) .…”

Section: Introductionmentioning

confidence: 99%

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Prognostic implications of cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy

Augsburger¹,

Corrêa²,

Trichopoulos³

2013

Arq. Bras. Oftalmol.

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Purpose: Determine whether cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy (FNAB) is a significant prognostic factor for death from metastasis. Methods: Retrospective analysis of cases of clinically diagnosed uveal melanoma evaluated by fine-needle aspiration biopsy from 1980 to 2006. Main outcome evaluated was death from metastasis. Associations between baseline clinical variables and cytopathologic classification were evaluated using cross-tabulation. Prognostic significance of cytopathologic classification was evaluated by Ka planMeier and Cox proportional hazards analysis. Results: Of 302 studied biopsies, 260 (86.1%) yielded sufficient cells for cytopathologic classification. Eighty of the 260 patients who had a sufficient specimen have already died (P=0.021), 69 from metastatic uveal melanoma. Cell type assigned by cytopathology was strongly associated with metastasis/metastatic death in this series (P=0.0048). Multivariate analysis showed cytopathologic classification to be an independently significant prognostic factor for metastatic death (P=0.0006). None of the 42 patients whose tumor yielded insufficient aspirates (sampled in at least two sites) have developed metastasis or died of metastasis thus far. Conclusion: In this series, cytopathology of fine-needle aspiration biopsy samples obtained from uveal melanomas was strongly prognostic of death from metastasis. Insufficiently aspirates (2 or more sites sampled) proved to be prognostic of a favorable outcome (i.e., not developing metastasis). Keywords

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic implications of cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy

Augsburger¹,

Corrêa²,

Trichopoulos³

2013

Arq. Bras. Oftalmol.

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“…When non-invasive diagnostic techniques are equivocal and the lesion requires therapy, we followed the recommendation by Char et al (1991) to routinely obtain a FNAB. Observation until documented growth is seen may be risky and patients may be lost during followup (Foulds l992).…”

Section: Discussionmentioning

confidence: 99%

Fine needle aspiration biopsy in selecting treatment for inconclusive intraocular disease

Eide

Syrdalen

Walaas

et al. 1999

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To evaluate the fine needle aspiration biopsy (FNAB) as a diagnostic tool in cases where it was impossible to make a definitive diagnosis with noninvasive techniques. Method: 80 consecutive patients with inconclusive diagnoses were examined by FNAB prior to decision of treatment. Biopsies were performed through a transscleral route in 50 eyes, an anterior chamber route in 16 eyes and a transvitreal approach in 14 eyes. The consequences of FNAB were analysed retrospectively. Results: FNAB confirmed malignancy in 59 eyes. Inconclusive material was obtained from 5 eyes judged clinically to be malignant disorders. One melanoma was misinterpreted as being a metastasis. In 47.5% of our patients this procedure altered the therapeutic plan and 25 patients were spared enucleation. The biopsy material was correctly diagnosed as benign in 16 cases. Conclusion: In eyes where the diagnosis remained uncertain after non-invasive tests, FNAB gave important information which greatly influenced our choice of treatment. FNAB contained sufficient tissue elements for cytological diagnosis in 77 eyes. Cytopathological interpretation failed once in relation to tumour type. The procedure of FNAB can be recommended for use in ambiguous tumour cases of the eye. Probably it should only be used in tumour centres with adequate cytology service.

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“…The cytoplasm of scattered cells contained abundant melanin granules, which were coarser than those usually seen in uveal tract melanomas. 40,41 Although an exact diagnosis could not be rendered, the FNAB was correctly interpreted as benign, with a differential diagnosis of melanocytoma 42 or adenoma of the pigmented ciliary epithelium. 15 A ciliary adenoma was found at iridocyclectomy.…”

Section: A B C Dmentioning

confidence: 99%

Fine Needle Aspiration Biopsy with Adjunct Immunohistochemistry in Intraocular Tumor Management

et al. 2005

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Cytopathologic Diagnosis of Benign Lesions Simulating Choroidal Melanomas

Cited by 35 publications

References 25 publications

Prognostic implications of cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy

Prognostic implications of cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy

Fine needle aspiration biopsy in selecting treatment for inconclusive intraocular disease

Fine Needle Aspiration Biopsy with Adjunct Immunohistochemistry in Intraocular Tumor Management

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