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J. Pe'er, S. Frenkel, K. Hendler, I. Kalickman, Y. Sherman, B. Maly, D. Ben Yehuda, V. Barak; Diagnosis of Vitreoretinal Lymphoma: The Use of Cytology, Gene-Rearrangement and Cytokines. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5010.
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Diagnosis of vitreoretinal lymphoma can be challenging. We compared the results of diagnosing suspected vitreoretinal lymphoma by cytology vs. PCR studies for IgH gene rearrangement and IL-10/IL-6 ratio.
Diluted vitreous fluid obtained in diagnostic vitrectomy from patients with suspected vitreoretinal lymphoma were delivered immediately after the surgery to our cytology laboratory; since 2005 also to our hematology laboratory for PCR studies; and since 2006 also to our cancer-markers laboratory for ELISA test for IL-10 and IL-6. (IL-10 is higher in lymphoma and IL-6 in inflammatory process).
In the last ten years we have examined 32 specimens for cytology, 15 for cytology and IgH gene-rearrangement, and 9 specimens for the cytology, IgH gene-rearrangement and IL-10 and IL-6. Among the 32 specimens that were examined by cytology, 15 were positive for lymphoma and the others were compatible with intraocular inflammation. Among the 15 specimens that were examined for gene-rearrangement, 6 were positive for lymphoma. One case with positive cytology and cytokines was negative for gene rearrangement. Among the nine specimens which were tested for the three diagnostic tools, four were positive for lymphoma by the three methods, three were negative for lymphoma by the three methods, compatible with intraocular inflammation, and in two cases, both with CNS lymphoma, the cytology and gene-rearrangement of the vitreous fluid were negative for lymphoma and the IL-10/IL-6 ratio was positive for lymphoma.
In our small series, the diagnosis of vitreoretinal lymphoma was comparable among the three methods we used, although not fully matched.
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