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

Davide Orlandi, Luca Maria Sconfienza, Francesca Lacelli, Michele Bertolotto, Simona Sola, Giovanni Mauri, Edoardo Savarino, Giovanni Serafini

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the diagnostic yield of ultrasound-guided core-needle biopsy of extra-ocular orbital lesions. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)1919-1924
Number of pages6
JournalEuropean Radiology
Issue number7
Publication statusPublished - Jul 2013


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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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