Fine needle aspiration biopsy with adjunct immunohistochemistry in intraocular tumor management.
OBJECTIVE
To assess the effectiveness of fine needle aspiration biopsy (FNAB), with and without immunohistochemistry (IHC), in the management of solid intraocular tumors.


METHODS
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.


CONCLUSIONS
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.
Faulkner-Jones
Beverly E
BE
Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Foster
William J
WJ
Harbour
J William
JW
Smith
Morton E
ME
Dávila
Rosa M
RM
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology; D005123:Eye / Q000473:pathology*; D005134:Eye Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006391:Hemangioma / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008223:Lymphoma / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000473:pathology; D008875:Middle Aged