Ultrasound-guided core-needle biopsy of extra-ocular orbital lesions
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To evaluate the diagnostic yield of ultrasound-guided core-needle biopsy of extra-ocular orbital lesions.
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.
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.
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.
• 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.
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- Ultrasound-guided core-needle biopsy of extra-ocular orbital lesions
Volume 23, Issue 7 , pp 1919-1924
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- Orbital mass
- Core-needle biopsy
- Ultrasound guidance
- Lymphoproliferative disease
- Immunohistochemical analysis
- Industry Sectors
- Author Affiliations
- 1. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Viale Benedetto XV 6, 16132, Genova, Italy
- 2. Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, 20097, San Donato Milanese, Milano, Italy
- 3. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Piazza Malan 2, 20097, San Donato Milanese, Milano, Italy
- 4. Struttura Complessa di Radiologia, Ospedale Santa Corona, ASL 2 Savonese, Via XXV Aprile 38, 17037, Pietra Ligure, Savona, Italy
- 5. Dipartimento di Radiologia, Ospedale di Cattinara, Università di Trieste, Strada di Fiume 447, 34149, Trieste, Italy
- 6. Struttura Complessa di Anatomia Patologica, Ospedale Santa Corona, ASL 2 Savonese, Via XXV Aprile 38, 17037, Pietra Ligure, Savona, Italy
- 7. Divisione di Gastroenterologia, Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Università degli Studi di Padova, Via Giustiniani 2, 35128, Padova, Italy