Impression Cytology for Clinical Management of Ocular Surface Tumors Using the Biopore Membrane

Abstract

Abstract: : Purpose: To report on the utility of the Biopore membrane for impression cytology of ocular surface squamous and pigmented tumors. Methods: A Biopore membrane (Millipore Corp., Bedford, MA) was used to obtain impression cytology specimens in four patients with ocular surface tumors. Correlation of cytology with histopathology was made in two patients whose lesions were excised: one patient with conjunctival melanoma and the other with conjunctival squamous papilloma. Correlation of cytology with the clinical picture was made in the remaining two patients whose lesions were treated with topical mitomycin C: one patient with conjunctival squamous cell carcinoma and the other with corneal intraepithelial neoplasia. Results: Excellent correlation was noted between the impression cytology and histopathology in both cases of excised lesions. [Figure 1. Impression cytology taken from a patient prior to excisional biopsy. Malignant melanoma cells with scattered pigment are shown. Figure 2. Histopathology of the same lesion showing malignant melanoma of the conjunctiva. (H&E stain, 20X).] In the two patients being treated with topical chemotherapy, impression cytology specimens were taken prior to each periodic treatment. The cytology demonstrated persisting malignant cells throughout the treatment period, which correlated with the clinical impression of persistent tumor throughout the treatment period. Conclusions: Impression cytology is a valuable tool for the diagnosis and monitoring of ocular surface tumors. This technique is especially useful for monitoring lesions treated with chemotherapy in which the gold standard of histopathology is unavailable. Unlike traditional cellulose acetate paper cytology which needs to be stained and evaluated immediately, specimens sampled with Biopore membrane can be immediately stored in 95% alcohol and processed anytime within one week. To our knowledge, this is the first report from the United States on the use of the Biopore membrane in the management of ocular surface tumors.  

Keywords: cytology • tumors • clinical (human) or epidemiologic studies: sys