Abstract
Purpose :
In the diagnosis of intraocular lymphoma, cytology with vitreous body samples has a low diagnosis rate because of the sparse number of cells and the destruction of cells during specimen preparation with conventional direct smear methods. Attempts have been made to improve the diagnosis rate by preparing cell block specimens. However, these are often difficult to prepare due to the availability of small quantities of samples. Liquid-based cytology (LBC) can increase cell accumulation by adsorbing atypical cells on the slide after fixation with a special fixation fluid. This can reduce cell destruction. We investigated the utility and safety of LBC for vitreous biopsy under perfusion in intraocular lymphoma.
Methods :
Vitreous biopsy was performed on intraocular lymphoma (19 eyes in 15 patients) between 2015 and 2021 at Yamagata University Hospital. Vitreous body samples were obtained with 25-gauge vitrectomy under perfusion using a cut-rate of 8,000 rotations/min, and LBC specimens were prepared (BD SurePath, USA). After the vitreous biopsy, cell block specimens were prepared with the samples obtained from the perfusion pack.
Results :
Atypical lymphocytes were identified in 14 of 19 eyes (73.7%) using LBC and in 13 of 19 eyes (68.4%) using cell block specimens. These atypical cells were also immunohistochemically positive for CD20 and Ki67. There were no complications during the vitreous biopsy under perfusion.
Conclusions :
In diagnosing intraocular lymphoma, LBC for vitreous biopsy under perfusion is a useful and safe method that can achieve pathological diagnosis at a level comparable to cell-block specimens.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.