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Alfaar AS, Yousef YA, W Wilson M, Hassanain O, Kakkassery V, Moustafa M, Kunbaz A, Esmael A, Strauß O. Declining incidence and improving survival of ocular and orbital lymphomas in the US between 1995 and 2018. Sci Rep 2024; 14:7886. [PMID: 38570585 PMCID: PMC10991268 DOI: 10.1038/s41598-024-58508-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/30/2024] [Indexed: 04/05/2024] Open
Abstract
This epidemiological study examined ocular and orbital lymphomas in the United States from 1995 to 2018, using data from the North American Association of Central Cancer Registries database of 87,543 patients with ocular and adnexal malignancies. We identified 17,878 patients (20.4%) with ocular and orbital lymphomas, with an age-standardized incidence rate (ASIR) of 2.6 persons per million (ppm). The incidence was the highest in the orbit (ASIR = 1.24), followed by the conjunctiva (ASIR = 0.57). Non-Hodgkin B-cell lymphoma was the most prevalent subtype (85.4%), particularly marginal-zone lymphoma (45.7%). Racial disparities were noted, with Asia-Pacific Islanders showing the highest incidence (orbit, 1.3 ppm). The incidence increased significantly from 1995 to 2003 (Average Percent Change, APC = 2.1%) but declined thereafter until 2018 (APC = - 0.7%). 5-year relative survival (RS) rates varied, with the highest rate for conjunctival lymphoma (100%) and the lowest for intraocular lymphoma (70.6%). Survival rates have generally improved, with an annual increase in the 5-year RS of 0.45%. This study highlights the changing epidemiological landscape, pointing to initial increases and subsequent decreases in incidence until 2003, with survival improvements likely due to advancements in treatment. These findings underscore the need for further research to investigate the root causes of these shifts and the declining incidence of ocular lymphoma.
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Affiliation(s)
- Ahmad Samir Alfaar
- Medical Neuroscience PhD Program, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität, Berlin Institute of Health, Humboldt-University, 10117, Berlin, Germany.
- Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool, UK.
| | - Yacoub A Yousef
- Department of Surgery/Ophthalmology, King Hussein Cancer Center, Amman, Jordan
| | - Matthew W Wilson
- St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Ophthalmology, University of Tennesse Health Science Center, Hamilton Eye Institute, Memphis, TN, USA
| | - Omneya Hassanain
- Research Department, Children's Cancer Hospital -Egypt, 57357, Cairo, Egypt
| | - Vinodh Kakkassery
- Ophthalmology Department, University Hospital of Schleswig-Holstein, Lübeck, Germany
- Ophthalmology Department, Klinikum Chemnitz, Chemnitz, Germany
| | - Mohanad Moustafa
- Ophthalmology Department, University Hospital Hairmyres, East Kilbride, Scotland, UK
| | - Ahmad Kunbaz
- Ophthalmology Department, Istanbul Medeniyet University, Istanbul, Turkey
| | - Amanne Esmael
- Ophthalmology Department, Cairo University, Cairo, Egypt
| | - Olaf Strauß
- Experimental Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität, Berlin Institute of Health, Humboldt-University, 10117, Berlin, Germany
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Wang KY, Xu TT, White LJ, Hodge DO, Dalvin LA. Incidence and clinical characteristics of pediatric ocular tumors in a Midwestern US population. J AAPOS 2023; 27:189.e1-189.e5. [PMID: 37453664 PMCID: PMC10528778 DOI: 10.1016/j.jaapos.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/07/2023] [Accepted: 05/07/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE To investigate the incidence and clinical characteristics of pediatric ocular tumors in a US Midwestern county population. METHODS Retrospective population-based cohort study of all Olmsted County, Minnesota, pediatric patients (<18 years old) diagnosed with any ocular neoplasm from January 1, 2006, to December 31, 2015. Subjects were identified via the Rochester Epidemiology Project, a record-linkage system that captures virtually all medical care provided in this county. Medical records were reviewed to confirm diagnoses. Age- and sex-adjusted incidence rates were calculated and adjusted to the 2010 Olmsted County, Minnesota, pediatric population. RESULTS There were 87 incident pediatric ocular tumor diagnoses, yielding an overall age- and sex-adjusted incidence rate of 24.0 per 100,000 per year (95% CI, 19.0-29.1). Females accounted for 46 cases (53%) cases, and 62 (85%) were White. Incidence rate for ocular tumors overall did not differ by patient age (P = 0.08) or sex (P = 0.47). All tumors were benign lesions. The most frequent adnexal/orbital, ocular surface, and intraocular tumors were epidermal inclusion cyst in 18 (21%) cases, conjunctival nevus in 10 (12%), and choroidal nevus in 18 (21%), respectively. The mean follow-up duration was 25.5 months (range, 7 days to 138.6 months), and benign tumor growth occurred in one conjunctival nevus. There were no cases of malignant transformation. CONCLUSIONS Pediatric ocular tumors were rare with an estimated incidence of approximately 1 in 4,200 pediatric patients in Olmsted County, Minnesota. All lesions were benign, with benign growth in only 1% of cases, and no tumors underwent malignant transformation.
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Affiliation(s)
- Kenny Y Wang
- Alix School of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Timothy T Xu
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
| | - Launia J White
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida
| | - David O Hodge
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida
| | - Lauren A Dalvin
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.
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Caputo A, Ciaparrone C, Fumo R, Zeppa P. Nodal and extra-nodal diagnosis of lymphoma by fine-needle cytology: Different diagnostic levels and clinical relevance. Diagn Cytopathol 2021; 49:968-969. [PMID: 34110718 DOI: 10.1002/dc.24810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 12/13/2022]
Affiliation(s)
- Alessandro Caputo
- Department of Medicine and Surgery, University of Salerno, Baronissi, Italy
| | - Chiara Ciaparrone
- Department of Pathology, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Rosalba Fumo
- Department of Pathology, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Pio Zeppa
- Department of Medicine and Surgery, University of Salerno, Baronissi, Italy.,Department of Pathology, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
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Bharani V, Kumar R, Gupta N, Srinivasan R, Rajwanshi A, Nahar U, Dey P. Fine-needle aspiration cytology in primary cutaneous tumors. Diagn Cytopathol 2017; 45:681-688. [PMID: 28474476 DOI: 10.1002/dc.23741] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 03/28/2017] [Accepted: 04/17/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND Fine-needle aspiration biopsy (FNAB) is occasionally used in the evaluation of primary skin tumors. However, in routine evaluation of any soft tissue swelling we encounter the cases of skin lesions. It is essential to know FNAB features of skin lesions. MATERIALS AND METHODS We present detailed cytomorphologic features with histologic correlation of 28 primary skin tumors, evaluated over a period of 4 years. RESULT An accurate diagnosis was provided in 42.8% cases, while benign or malignant nature was correctly established in 82.1% cases. CONCLUSIONS The most common cause of incorrect diagnosis was sampling error and a definitive diagnosis was not provided in adnexal tumors due to overlap of cytologic features and lack of availability of architectural features. The knowledge of cytological features of the skin adnexal tumor is helpful to avoid any mistaken diagnosis. Diagn. Cytopathol. 2017;45:681-688. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Vani Bharani
- Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajesh Kumar
- Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nalini Gupta
- Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranab Dey
- Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Hassan WM, Bakry MS, Hassan HM, Alfaar AS. Incidence of orbital, conjunctival and lacrimal gland malignant tumors in USA from Surveillance, Epidemiology and End Results, 1973-2009. Int J Ophthalmol 2016; 9:1808-1813. [PMID: 28003984 DOI: 10.18240/ijo.2016.12.18] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/22/2016] [Indexed: 12/24/2022] Open
Abstract
AIM To determine the types and incidence of tumors affecting the orbit, conjunctiva and lacrimal glands and to study the trend line of these tumors in the United States from 1973 to 2009. METHODS We used the publicly available Surveillance, Epidemiology and End Results (SEER) database registries to determine the incidence rates. Age was adjusted to the 2000 US Standard Population. Patients were stratified according to age group, gender, race and histological grouping of tumor lesions. Three age groups were defined: 0-19, 20-49 and ≥50y. Annual percentage changes were calculated to examine trends. RESULTS The overall age adjusted incidence rate was 3.39 (95%CI: 3.27-3.52) per million person-years. The tumors were more prevalent in age group ≥50 counting 9.51 (95%CI: 9.11-9.92) per million person-years. Most of the soft tissue sarcomas occurred in the young age with incidence rate of 0.35 (95%CI: 0.28-0.42) per million person-years. Lymphomas were the dominant subtype in the adult population with incidence rate of 5.74 (95%CI: 5.43-6.06) per million person-years. Incidence rates were higher in males than females with an overall rate ratio of 1.31 (95%CI: 1.21-1.41) mainly caused by the increase in carcinoma subtypes. White race had a higher tumor incidence with a rate ratio of 1.47(95%CI: 1.25-1.73) driven by the higher incidence of most histological subtypes. Orbital tumors showed a higher incidence rate followed by conjunctival and lacrimal gland tumors with incidence rates of 1.59, 1.37 and 0.43 per million person-years respectively. The trend line of overall incidence of tumors showed a significant increase (APC=3.11, 95%CI: 2.61-3.61) mainly due to increase of lymphomas. This increase was higher than the increase of lymphomas at other sites. CONCLUSION Orbital, conjunctival and lacrimal gland malignant tumors differ among children and adults. Over the years there has been a noticeable increase in incidence rates of orbital and lacrimal gland tumors mainly caused by an increase in lymphomas and an apparent increase due to advances in diagnostic techniques. ICD-O-3 topographical coding should be improved to consider the different orbital bones and ocular structures.
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Affiliation(s)
- Waleed M Hassan
- Research Department, Children Cancer Hospital Egypt 57357, Cairo 11441, Egypt
| | - Mohamed S Bakry
- Research Department, Children Cancer Hospital Egypt 57357, Cairo 11441, Egypt
| | | | - Ahmad S Alfaar
- Research Department, Children Cancer Hospital Egypt 57357, Cairo 11441, Egypt; Ophthalmology Department, Charité-Universtätsmedizin Berlin, Berlin 10117, Germany
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Khan L, Malukani K, Malaiya S, Yeshwante P, Ishrat S, Nandedkar SS. Role of Fine Needle Aspiration Cytology as a Diagnostic Tool in Orbital and Adnexal Lesions. J Ophthalmic Vis Res 2016; 11:287-95. [PMID: 27621787 PMCID: PMC5000532 DOI: 10.4103/2008-322x.188397] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose: To evaluate the role of fine needle aspiration (FNAC) as a diagnostic tool in cases of orbital and ocular adnexal masses. Cytological findings were correlated with histopathological diagnosis wherever possible. Methods: FNAC was performed in 29 patients of different age groups presenting with orbital and ocular adnexal masses. Patients were evaluated clinically and investigated by non-invasive techniques before fine needle aspiration of the masses. Smears were analyzed by a cytologist in all cases. Further, results of cytology were compared with the histopathological diagnosis. Results: The age of patients ranged from 1 to 68 years (mean: 29.79±19.29). There were 14 males and 15 females with a male to female ratio of 0.93:1. Out of 29 cases, 26 aspirates were cellular. Cellularity was insufficient in three (10.34%) aspirates. Out of 26 cellular aspirates, 11 were non-neoplastic while 15 were neoplastic on cytology. Subsequent histopathologic examination was done in 21/26 cases. Concordance rate of FNAC in orbital and ocular adnexal mass lesions with respect to the precise histologic diagnosis was 90%. Conclusion: When properly used in well-indicated patients (in cases where a diagnosis cannot be made by clinical and imaging findings alone), FNAC of orbital and periorbital lesions is an invaluable and suitable adjunct diagnostic technique that necessitates close cooperation between the ophthalmologist and cytologist. However, nondiagnostic aspirates may sometimes be obtained, and an inconclusive FNAC should not always be ignored.
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Affiliation(s)
- Lubna Khan
- Department of Ophthalmology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Kamal Malukani
- Department of Pathology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Siddharth Malaiya
- Department of Ophthalmology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Prashant Yeshwante
- Department of Pathology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Saba Ishrat
- Department of Ophthalmology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Shirish S Nandedkar
- Department of Pathology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
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Wiktorin AC, Dafgård Kopp EM, Tani E, Söderén B, Allen RC. Fine-Needle Aspiration Biopsy in Orbital Lesions: A Retrospective Study of 225 Cases. Am J Ophthalmol 2016; 166:37-42. [PMID: 27018233 DOI: 10.1016/j.ajo.2016.03.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 03/11/2016] [Accepted: 03/14/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe and analyze results from the fine-needle aspiration biopsy (FNAB) technique, used as a diagnostic tool, in patients with orbital lesions. DESIGN Retrospective case series. METHODS setting: Institutional (Karolinska Hospital, Stockholm). STUDY POPULATION 207 patients with 210 orbital lesions. INTERVENTION 225 FNABs of the orbit. MAIN OUTCOME MEASURES Successful diagnosis from FNAB. RESULTS Of the 210 orbital lesions evaluated with FNAB, a successful cytologic diagnosis was achieved in 176 (84%). In more than half of the orbital lesions (54%), the FNAB diagnosis in addition to imaging appearance, clinical appearance, and clinical history provided sufficient information for treatment, and the patient did not require an incisional or excisional biopsy. Ninety-seven patients underwent additional excisional or incisional biopsy; FNAB diagnoses and the histopathologic diagnoses corresponded in 87% of the cases with an intraclass correlation coefficient of 0.84 (95% confidence interval [CI] 0.76-0.90). The difference was statistically significant between the ability to make a successful cytologic FNAB diagnosis in palpable lesions vs nonpalpable lesions (successful diagnosis in 90% [CI = 85%-95%] vs 75% [CI = 66%-84%]; P < .01). Neither the orbital quadrant location, nor the radiologic appearance (diffuse vs encapsulated), nor size of the lesion affected the success of FNAB diagnoses (all P > .7). There was a complication in 6 cases (3%). All complications were temporary and none led to permanent damage. CONCLUSIONS FNAB proved effective and exceedingly safe. With the current healthcare climate of minimally invasive surgery and cost control, FNAB should be considered as a valid alternative to open surgery in the evaluation and management of orbital lesions.
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Pagni F, Jaconi M, Smith AJ, Brenna A, Valente MG, Leoni S, Leni D, Vacirca F, Sozzi D. The Role of Fine Needle Aspiration of Orbital Lesions: A Case Series. Acta Cytol 2016; 60:31-8. [PMID: 26986454 DOI: 10.1159/000444385] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 02/02/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This paper analyzes a series of ultrasound (US)-guided orbital fine needle aspirations (FNAs) which provide diagnostic information that cytopathologists approaching orbital lesions for the first time can find useful and underlines the importance of teamwork. STUDY DESIGN The investigators retrospectively obtained data from 24 consecutive orbital FNAs. For all patients, a complete clinicoradiological database was created. FNAs were performed under US guidance with 25-gauge needles and an aspiration biopsy syringe gun, and sent to the Department of Pathology for examination and data management. RESULTS The mean age of the patients was 54 years. Imaging studies included US, magnetic resonance imaging and computed tomography scans; 9 lesions involved the right orbit and 15 the left orbit. The mean lesion size was 23.6 ± 7.2 mm. After microscopic examination, 7 smears were labeled as 'nondiagnostic', while in 17 cases a definitive diagnosis was proposed, which always proved to be correct (70.8%, specificity = 100%). CONCLUSIONS The investigators believe that FNA biopsy of orbital masses is a necessary step; its weaknesses lie in the particularly delicate site of sampling and the extreme heterogeneity of lesions. Nevertheless, when orbital FNA is performed within a well-coordinated multidisciplinary team, it is a powerful tool that can be used to define the most appropriate management of these patients.
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Affiliation(s)
- Fabio Pagni
- Division of Pathology, University Milano-Bicocca, San Gerardo Hospital, Monza, Italy
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Agrawal P, Dey P, Lal A. Fine-needle aspiration cytology of orbital and eyelid lesions. Diagn Cytopathol 2013; 41:1000-11. [PMID: 23457033 DOI: 10.1002/dc.22972] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 01/01/2013] [Indexed: 11/12/2022]
Abstract
Fine-needle aspiration cytology (FNAC) of orbital lesions is now increasingly popular. Because of its unique location and the occurrence of varieties of lesions, diagnosis of orbital lesion is a challenge to the cytopathologists. FNAC of orbital and eyelid tumors is a suitable diagnostic technique that necessitates close co-operation between the ophthalmologist and pathologist. No radical procedure should be planned on the basis of FNAC, but it allows the diagnosis of a new primary lesion or the recurrence or metastasis of a tumor and can be done to identify lesions that require either specific medical therapy, as in nonresectable, inflammatory, and lymphoid tumors, or limited surgery for benign resectable neoplasms. With the help of various ancillary techniques a definitive diagnosis is possible on orbital and adnexal lesions. It is essential to have a detailed knowledge on the FNAC of these lesions and their potential pitfalls. In this present review, we have discussed various orbital lesions, their clinical presentations, cytomorphology, and ancillary techniques to confirm the diagnosis.
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Affiliation(s)
- Pallavi Agrawal
- Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Orlandi D, Sconfienza LM, Lacelli F, Bertolotto M, Sola S, Mauri G, Savarino E, Serafini G. Ultrasound-guided core-needle biopsy of extra-ocular orbital lesions. Eur Radiol 2013; 23:1919-24. [DOI: 10.1007/s00330-013-2776-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 12/15/2012] [Accepted: 12/19/2012] [Indexed: 12/26/2022]
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