title: Ultrasound-guided core-needle biopsy of extra-ocular orbital lesions.
abstract: OBJECTIVE
  To evaluate the diagnostic yield of ultrasound-guided core-needle biopsy of extra-ocular orbital lesions.
  
  
  METHODS
  Fifty-five patients with monolateral exophthalmos prospectively underwent computed tomography (CT) to investigate the presence of an extra-ocular mass (n = 25). Excluding benign lesions (n = 7) and patients in whom CT revealed an unknown primitive malignancy (n = 5), 13 patients (7 male, 6 female; mean age 62 ± 16 years) underwent ultrasound. Lesion appearance (echotexture, power Doppler vascularisation), size, position with respect to the cone and to the globe were recorded. Ultrasound-guided biopsies were performed (automatic, n = 9; semi-automatic 18-G needle, n = 4). Sample adequacy and complication rate were recorded.
  
  
  RESULTS
  Ultrasound demonstrated hypoechoic lesions with mild power Doppler vascularity, that were completely (n = 7) or partially extra-conal (n = 6), located laterally (n = 8) or posteriorly (n = 5) to the globe. Mean size was 3.25 cm. All biopsies yielded adequate material for histological and immunohistochemical analysis (nine non-Hodgkin's lymphomas, two adenocarcinomas, one lymphoid hyperplasia, one inflammatory pseudotumour). Complications included cutaneous eyelid haematoma (n = 3) and retro-bulbar haematoma (n = 1), treated conservatively and resolved at 10-day follow-up. No immediate or delayed vision reduction was reported.
  
  
  CONCLUSIONS
  Ultrasound-guided core-needle biopsy of extra-ocular orbital lesions is feasible and accurate, being free from long-term complications. This procedure provided 100 % adequate samples to achieve final diagnosis.
  
  
  CONCLUSIONS
  • Ultrasound-guided core-needle biopsy of extra-ocular orbital lesions seems feasible and accurate. • In this series it provided a final diagnosis in 13/13 cases. • It appears free from long-term complications. • It provides immunohistochemical analysis of the specimen. • It should represent a valuable alternative to surgical biopsy.
authors: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Viale Benedetto XV 6, 16132 Genova, Italy.
authors: Davide
authors: D
authors: Orlandi
authors: Luca Maria
authors: LM
authors: Sconfienza
authors: Francesca
authors: F
authors: Lacelli
authors: Michele
authors: M
authors: Bertolotto
authors: Simona
authors: S
authors: Sola
authors: Giovanni
authors: G
authors: Mauri
authors: Edoardo
authors: E
authors: Savarino
authors: Giovanni
authors: G
authors: Serafini
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods; D005094:Exophthalmos / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000175:diagnosis; D061705:Image-Guided Biopsy / Q000379:methods; D007150:Immunohistochemistry; D007249:Inflammation / Q000175:diagnosis; D008206:Lymphatic Diseases / Q000175:diagnosis; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000473:pathology; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018608:Ultrasonography, Doppler / Q000379:methods*