European Radiology

, Volume 23, Issue 7, pp 1919–1924 | Cite as

Ultrasound-guided core-needle biopsy of extra-ocular orbital lesions

  • Davide Orlandi
  • Luca Maria SconfienzaEmail author
  • Francesca Lacelli
  • Michele Bertolotto
  • Simona Sola
  • Giovanni Mauri
  • Edoardo Savarino
  • Giovanni Serafini



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.

Key Points

• 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.


Orbital mass Core-needle biopsy Ultrasound guidance Lymphoproliferative disease Immunohistochemical analysis 


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Davide Orlandi
    • 1
  • Luca Maria Sconfienza
    • 2
    • 3
    Email author
  • Francesca Lacelli
    • 4
  • Michele Bertolotto
    • 5
  • Simona Sola
    • 6
  • Giovanni Mauri
    • 2
  • Edoardo Savarino
    • 7
  • Giovanni Serafini
    • 4
  1. 1.Scuola di Specializzazione in RadiodiagnosticaUniversità degli Studi di GenovaGenovaItaly
  2. 2.Servizio di RadiologiaIRCCS Policlinico San DonatoSan Donato MilaneseItaly
  3. 3.Dipartimento di Scienze Biomediche per la SaluteUniversità degli Studi di MilanoSan Donato MilaneseItaly
  4. 4.Struttura Complessa di RadiologiaOspedale Santa CoronaPietra LigureItaly
  5. 5.Dipartimento di Radiologia, Ospedale di CattinaraUniversità di TriesteTriesteItaly
  6. 6.Struttura Complessa di Anatomia PatologicaOspedale Santa CoronaPietra LigureItaly
  7. 7.Divisione di Gastroenterologia, Dipartimento di Scienze Chirurgiche, Oncologiche e GastroenterologicheUniversità degli Studi di PadovaPadovaItaly

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