Fine needle aspiration biopsy in pediatric ophthalmic tumors and pseudotumors.
Fine needle aspiration biopsy in pediatric ophthalmic tumors and pseudotumors.
复制标题
小儿眼科肿瘤和假瘤的细针抽吸活检。
作者：
B. O'hara;H. Ehya;J. Shields;J. Augsburger;C. Shields;R. Eagle
在八年期间（1983年至1990年）约500细针穿刺活检（FNAB）的眼部病变进行了处理，在我们的实验室。其中81例病例来自77例儿科患者（年龄范围为4周至16岁），是本研究的受试者。标本包括73眼内和8眼眶吸出物。其中44例标本来自诊断程序，而37例标本来自眼球摘除后立即进行的手术标本。8例FNAB（4例诊断性和4例去核后）被认为不足以进行细胞学诊断。其余73例中，38例被诊断为恶性（视网膜母细胞瘤34例，髓上皮瘤3例，横纹肌肉瘤1例），所有病例均经随后的组织学检查证实。4例被诊断为可疑恶性肿瘤，所有这些都被证明是恶性的（两个视网膜母细胞瘤，两个横纹肌肉瘤）。一个眼眶吸出物含有神经胶质来源的细胞，并在组织学上被证实为毛细胞性星形细胞瘤。10例报告为符合Coats病;所有病例均经组织学检查（3例）或临床随访（7例）证实为良性。其余20例良性抽吸物（13例有炎性细胞，6例有巨噬细胞，1例有血液）经组织学检查（4例）或临床随访（16例）证实为良性。没有假阳性诊断。FNAB的总体准确性为95%，细胞学解释的准确性为100%。我们的结论是，细针吸活检是一种可靠和准确的诊断方式在选定的儿科眼科疾病的评估。
In an eight-year period (1983-1990) approximately 500 fine needle aspiration biopsies (FNABs) of eye lesions were processed in our laboratory. Eighty-one of the cases, obtained from 77 pediatric patients (ranging from 4 weeks to 16 years of age), were the subject of this study. The specimens included 73 intraocular and 8 orbital aspirates. Forty-four of the specimens were from diagnostic procedures, whereas 37 were obtained from surgical specimens immediately after enucleation. Eight FNABs (four diagnostic and four postenucleation) were deemed inadequate for cytologic diagnosis. Of the remaining 73 cases, 38 were diagnosed as malignant (34 retinoblastomas, 3 medulloepitheliomas, 1 rhabdomyosarcoma), and all were confirmed upon subsequent histologic examination. Four cases were diagnosed as suspicious for malignancy; all of them proved to be malignant (two retinoblastomas, two rhabdomyosarcomas). One orbital aspirate contained cells suggestive of a glial origin and was confirmed histologically as pilocytic astrocytoma. Ten cases were reported as compatible with Coats' disease; all were confirmed to be benign by histologic examination (three cases) or clinical follow-up (seven cases). The remaining 20 benign aspirates (13 with inflammatory cells, 6 with macrophages and 1 with blood) proved to be from benign conditions by histologic examination (4 cases) or clinical follow-up (16 cases). There were no false-positive diagnoses. The overall accuracy of FNAB was 95%, and the accuracy of cytologic interpretation was 100%. We conclude that FNAB is a reliable and accurate diagnostic modality in the assessment of selected pediatric ophthalmic diseases.