Agreement between ultrasonography and histopatologic findings in diagnosing retinoblastoma

Abstract

Retinoblastoma is a rare eye tumor of childhood that represents the most common intraocular malignancy of
infancy and childhood. Diagnosis of retinoblastoma are based on ophthalmological examination and imaging, including
ultrasonography (USG). In a typical case of retinoblastoma, it will provide a nearly pathognomonic picture with
cottage-cheese calcification, with density higher than the sclera and high internal reflectivity in USG findings.
Histopathologic examination is a gold standard formalignany cases and Flexner-Wintersteiner cells is a pathognomonic
sign. The aim of this study is to determine the value of an agreement test comparing USG as a preoperative
diagnostic tool with histopatologic examination in diagnosing retinoblastoma. This study was an observational
agreement test. All of the patients with clinically suspected intraocular lession were examined with USG followed
by surgery and histopathologic examination in Eye Clinic of Dr. Sardjito Hospital, Yogyakarta. The result of USG
examinationswas interpreted by one eye oncologist and the histopathologic readingwas performed by one anatomical
pathologist. Data were analyzed to determine the agreement value. Thirty three eyes, 21 eyes were retinoblastoma
suspected and 12 eyes were non-retinoblastoma suspected based on USG examination), were observed in this
study. One eye (3.03%) was false positive case and 1 was false negative case. The Kappa value of agreement test
was 0.87. In conclusion, ultrasonography of the eye as a pre-operative diagnostic tool had an excellent agreement
compared with histopathological examination as a gold standard in retinoblastoma.
Key words: eye-retina-intraocular malignancy-diagnosis-Kappa value