The utility of fine needle aspiration cytology in orbital haematolymphoid neoplasms

Abstract

Background Orbital hematolymphoid lesions are rare and usually encountered in elderly patients. Orbital lesions are not easy to biopsy: hence fine needle aspiration cytology (FNAC) can be a very good diagnostic modality for these lesions. Materials and Methods Cases of orbital masses subjected to FNAC dating from 2013 to 2020 were retrieved from our archives. A total of 16 cases with biopsy confirmation were included. All clinical details, the type of procedure, details of the immunocytochemistry (ICC) performed on smear, follow‐up biopsy, and their haematological work‐up were analysed in detail. Results Sixteen biopsy‐confirmed cases had been diagnosed as orbital haematolymphoid lesions on cytomorphology and further categorised with ancillary studies including ICC. In twelve instances, the cytology impression was congruent with the histopathological diagnosis and eight of the sixteen cases (50%) proved to be primary orbital lymphoma. Four were secondary orbital lymphomas and the remaining four included one case each of plasmacytoma, myeloid sarcoma, Rosai‐Dorfman disease and angiolymphoid hyperplasia with eosinophilia. Conclusion FNAC is a minimally invasive procedure for diagnosing most of the haematolymphoid orbital lesions and it has a rapid turnaround time. The accuracy of cytomorphology combined with ICC on smears/cell blocks can be as good as a biopsy for exact categorisation. Additionally, aspirate smears are preferred samples for cytogenetics compared to formalin‐fixed tissue blocks, as molecular cytogenetics techniques are frequently employed for diagnostic, prognostic, and therapeutic purposes.

Fine‐needle aspiration cytology for the diagnosis of plasma cell neoplasms in the head and neck region: A systematic analysis of the literature

“…They also reported 100% sensitivity and 87% specificity among all lesions studied 108 . Other authors showed that 75% of orbital haematolymphoid neoplasms were accurately diagnosed by cytology 109 . Interestingly, our review detected that 26.6% of the additional cases were misdiagnosed (i.e., inconclusive results or a diagnosis other than PCN).…”

“…108 Other authors showed that 75% of orbital haematolymphoid neoplasms were accurately diagnosed by cytology. 109 Interestingly, our review detected that 26.6% of the additional cases were misdiagnosed (i.e., inconclusive results or a diagnosis other than PCN). These discrepancies, however, were identified as PCN in a subsequent biopsy.…”

“…We found that the majority of cases underwent immunophenotyping of conventional biopsy tissue. It is worth mentioning, however, that immunocytochemical staining with a smear or cell block has been used for immunophenotyping of haematolymphoid neoplasms with promising results 109 . Indeed, both methods are particularly suitable in the diagnostic investigation of recurrent and systemic PCM involvement.…”

Advances in CRISPR Based Biosensing Strategies for Cancer Diagnosis

“…Stephen et al 7 explored fine needle aspiration cytology (FNAC) for diagnosing orbital lymphoid tissue tumors. FNAC, being a minimally invasive and effective method, provides essential cytological diagnostic information for orbital lymphoid tissue tumors, particularly malignant tumors.…”

Myeloid Sarcoma: Features in Cytological Preparations and the Utility of Rapid On-Site Evaluation (ROSE) in Triage

“…MS is a highly aggressive disease and shows a poor complete response rate after standard chemotherapy [14]; however, the grim survival of this disease can be decelerated to some extent with timely initiation of appropriate therapy that is contingent upon a prompt, accurate, and complete diagnosis. The morphologic features of MS in cytologic preparations such as FNA smears, touch preparations (TPs), and ThinPrep have been reported only sporadically in the literature, and the majority of the published data come from single case reports or small case series [15][16][17][18][19][20][21]. Failure to recognize MS in cytologic specimens combined with the aforementioned complexities associated with this diagnosis may delay or even misdiagnose this dismal disease.…”