Biopsy in indeterminate intraocular tumors
Biopsy in indeterminate intraocular tumors
复制标题
DOI：
10.1016/s0161-6420(01)00931-9
复制
发表时间：
2002-02-01
期刊：
影响因子：
13.7
通讯作者：
Bornfeld, N
中科院分区：
文献类型：
--
作者：
Bechrakis, NE;Foerster, MH;Bornfeld, N
目的：描述一种眼内活检技术，该技术可对临床上无法分类的葡萄膜肿瘤进行准确的组织病理学诊断。设计：回顾性非比较性连续干预病例系列。参与者/方法：对11例无法分类的虹膜肿瘤患者，采用玻璃体切割器通过两孔透明角膜入路或三孔透明角膜入路进行眼内活检。经平坦部玻璃体切除术治疗脉络膜肿瘤23例将标本福尔马林固定并进行石蜡处理。所有病例均进行了苏木精-伊红和过碘酸-希夫染色，在无法进行常规分类的病例中使用碱性磷酸酶进行了额外的免疫组化染色，碱性磷酸酶法。结果：97%的病例（n = 33）可以通过活检标本建立明确的诊断。73%的虹膜肿瘤病例（n = 8）和57%的后眼内肿瘤病例（n = 13）可诊断为黑色素瘤。其他诊断包括痣、转移、血管增生性肿瘤、出血、神经胶质增生和巩膜炎。并发症发生在4例：玻璃体出血发生两次，一个不确定的活检结果，和眼内肿瘤扩散发生一次，分别。平均随访44 months.Conclusions：眼内活检玻璃体切割器允许福尔马林固定石蜡包埋的肿瘤组织的组织病理学检查后，没有增加肿瘤相关的死亡率。这增加了诊断的准确性，避免了经巩膜活检技术所见的眼外肿瘤扩散的风险。(C)2002年，美国眼科学会。
Objective: To describe an intraocular biopsy technique that allows accurate histopathologic diagnosis in cases of clinically unclassifiable uveal tumors.Design: Retrospective noncomparative consecutive interventional case series.Participants/Methods: Intraocular biopsies were performed by a vitreous cutter either by a two-port clear cornea approach in 11 patients with unclassifiable iris tumors or by a three-port pars plana vitrectomy in 23 patients with unclassifiable choroidal tumors. Specimens were formalin fixed and paraffin processed. Hematoxylineosin and periodic acid-Schiff stains were performed in all cases, with additional immunohistochemical stains using the alkaline phosphatase, alkaline phosphatase method in cases that could not be conventionally classified.Main Outcome Measures. Clinical observation and histopathologic examination of intraocular biopsies.Results: In 97% of cases (n = 33) a definite diagnosis could be established by the biopsy specimen. A melanoma could be diagnosed in 73% of cases (n = 8) of iris tumors and in 57% of cases (n = 13) of posterior intraocular tumors. Other diagnoses included nevus, metastasis, vasoproliferative tumor, hemorrhage, gliosis, and scleritis. Complications were encountered in four cases: a vitreous hemorrhage occurred twice, an inconclusive biopsy result, and an intraocular tumor spread occurred once, respectively. No increased tumor-related mortality was observed after a mean follow-up of 44 months.Conclusions: Intraocular biopsy by a vitreous cutter allows the histopathologic examination of formalin-fixed paraffin-embedded tumor tissue. This increases the diagnostic accuracy, avoiding the risk of extraocular tumor spread seen with transscleral biopsy techniques. (C) 2002 by the American Academy of Ophthalmology.