Fineneedle Aspiration Biopsy

The main advantage of the FNAB over the other biopsy techniques is that it can be performed with simple local anesthesia or, in some cases, even without anesthesia in a rapid fashion in the clinic. The principal disadvantage is that if postbiopsy orbital hemorrhage occurs, the closed orbit may make management more difficult. Another disadvantage from the standpoint of tissue sampling is that the material obtained is usually scanty and can be examined only by cytopathology, ruling out histopathology. Furthermore, the material obtained with FNAB would be insufficient in most cases for other studies including

FIGURE 12.4. An FNAB procedure performed under CT guidance. Note that the position of the needle can easily be followed on the monitor.

flow cytometric studies, immunophenotyping, and electron microscopy.

Martin and Ellis are the first investigators credited with performing tumor biopsy, using a small gauge needle.6 The procedure, although it was initiated in the United States during the 1930s, failed to be adapted universally. Instead it became popular in Europe among the hematologists and oncologists during the late 1950s and early 1960s.7,8 In the 1970s interest in cytopathology and FNAB was revitalized in the United States, and more and more cytopathologists were trained in this subspecialty.9 Furthermore, advances in radiologic imaging techniques, including ul-trasonography, computed tomography (CT), and fluoroscopy, opened the door for surgeons and radiologists to perform FNAB.10 The first use of FNAB in orbital tumors was by Schyberg.11 In the United States, however, it was popularized by Kennerdell and coworkers in the late 1970s and early 1980s.4,5

0 0

Post a comment