Fine needle aspiration biopsy with liquid-based cytology and adjunct immunohistochemistry in intraocular melanocytic tumors.
OBJECTIVE
To determine the efficacy of liquid-based cytology (LBC) and immunohistochemistry in the evaluation of fine needle aspiration biopsy (FNAB) of intraocular melanocytic tumors.


METHODS
Cytologic diagnosis was necessary in 25 patients with intraocular melanocytic tumors to deliver a therapeutic course of treatment. The patients' clinical, cytologic, and histologic diagnoses were correlated. All samples were stained with hematoxylin and eosin, and studied through standardized monolayer techniques, with a mean cellular concentration of 60,000 cells/mm2. Immunohistochemistry was performed using Vimentin, S 100, HMB 45, Melan A, cytokeratin, and as prognostic factors, B and T lymphocyte, CD68 (macrophage), and antibody Ki 67 (growth factor).


RESULTS
The positive predictive value was 100%; the negative predictive value was 80%. Sensitivity and specificity of LBC for detecting malignancy were 95.2% and 100%, respectively. The FNAB LBC with immunohistochemistry findings resulted in a revision of treatment in 32% of patients. There was no evidence of local tumor dissemination or a recurrence associated with biopsy in any patient.


CONCLUSIONS
Fine needle aspiration biopsy (LBC and immunohistochemistry) is a safe, sensitive, and specific method of establishing tissue diagnosis in a subset of patients with intraocular melanocytic tumors, particularly in cases where sample material is scarce. The routine use of immunohistochemical stain increases the diagnostic utility, and prognosis factor determination may change clinical management.
Pelayes
David E
DE
Department of Ophthalmology, LIOCiV (Laboratory of Ophthalmic Research and Visual Sciences), School of Medicine, Buenos Aires University, Buenos Aires, Argentina. davidpelayes@gmail.com
Zárate
Jorge O
JO
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D044963:Biopsy, Fine-Needle; D003584:Cytological Techniques; D004416:Dysplastic Nevus Syndrome / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D015353:Eye Enucleation; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D032801:Iridectomy; D008297:Male; D008545:Melanoma / Q000737:chemistry / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis; D009508:Nevus, Pigmented / Q000737:chemistry / Q000175:diagnosis* / Q000601:surgery; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014604:Uveal Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins