Vitreous Seeds in Retinoblastoma Clinicopathologic Classification and Correlation
Vitreous Seeds in Retinoblastoma Clinicopathologic Classification and Correlation
复制标题
DOI：
10.1016/j.ophtha.2017.04.015
复制
发表时间：
2017-10-01
期刊：
影响因子：
13.7
通讯作者：
Chevez-Barrios, Patricia
中科院分区：
文献类型：
--
作者：
Amram, Alec L.;Rico, Grecia;Chevez-Barrios, Patricia
目的：最近的视网膜母细胞瘤玻璃体种子的分类方案在预测治疗反应方面显示出希望。研究设计：回顾性研究对象：2010年至2015年在休斯顿视网膜母细胞瘤中心病理科接受的眼球摘除患者。方法：对视网膜母细胞瘤患者眼球摘除的肉眼照片进行分析，选择有玻璃体种子的患者。选择有足够临床病理相关资料的病例进行进一步分析，并回顾临床照片。常规组织病理学切片进行审查，并与临床和宏观照片进行比较。种子被分为1型（“尘”）、2型（“球”）或3型（“云”）。为了确认巨噬细胞的存在，使用CD 68免疫组织化学染色。Synaptophysin被用来染色视网膜母细胞瘤cells.Main Outcome Measures：相关临床玻璃体种子类型与组织病理学features.Results：共有14只眼睛与足够数量的肿瘤种子沿着与临床和宏观摄影相关性被选中，从总共138只眼睛审查。1型种子由单个活肿瘤细胞和分散的巨噬细胞组成。2型种子由2种亚形态组成：充满活细胞的球体和外缘有活细胞但中心有坏死细胞的球体。3型种子由超过90%的坏死材料组成，在其外缘处混合有少量巨噬细胞和活细胞。未处理（8/14）和先前处理（6/14）的眼睛显示出每种类型的种子相似的组织病理学特征。治疗的眼睛有更多的类型1和3 seeds.Conclusions：我们提供了第一个组织病理学相关的临床分类方案的玻璃体种子视网膜母细胞瘤。“尘埃”是由分散的单细胞与巨噬细胞交替形成的。具有半透明中心的“球体”包含多层存活的肿瘤细胞，这些细胞会脱落单细胞，并且在临床上可能更具攻击性。“云”种子主要由坏死物质组成，这解释了它们缺乏治疗反应。预处理的眼睛显示出与未处理的眼睛在形态上相似的肿瘤种子。玻璃体种子类型的基础组织病理学知识是分类的基本组成部分，并可能有助于了解临床治疗反应。(C)2017年美国眼科学会
Purpose: A recent classification scheme for retinoblastoma vitreous seeds has shown promise in predicting treatment response. For the first time, we correlate this clinical classification scheme with its histopathologic features.Design: Retrospective review.Participants: Enucleated eyes received at the pathology department of the Retinoblastoma Center of Houston from 2010 to 2015.Methods: Macroscopic photographs of the enucleated eyes of patients with retinoblastoma were analyzed to select those with vitreous seeds. Cases with adequate material for clinicopathologic correlation were selected for further analysis, and clinical photographs were reviewed. Routine histopathologic slides were reviewed and compared with the clinical and macroscopic photographs. Seeds were classified as type 1 ("dust"), type 2 ("sphere"), or type 3 ("cloud"). To confirm the presence of macrophages, CD68 immunohistochemical staining was used. Synaptophysin was used to stain retinoblastoma cells.Main Outcome Measures: To correlate clinical vitreous seed type with histopathologic features.Results: A total of 14 eyes with adequate amounts of tumor seeds along with clinical and macroscopic photographic correlation were selected from a total of 138 eyes reviewed. Type 1 seeds consisted of individual viable tumor cells and scattered macrophages. Type 2 seeds consisted of 2 submorphologies: spheres with viable cells throughout and spheres with an outer rim of viable cells but necrotic cells centrally. Type 3 seeds were composed of more than 90% necrotic material admixed with few macrophages and viable cells at their outer rim. Untreated (8/14) and previously treated (6/14) eyes showed similar histopathologic features for each type of seeds. Treated eyes had more type 1 and 3 seeds.Conclusions: We provide the first histopathologic correlation of the clinical classification scheme for vitreous seeds in retinoblastoma. "Dust" is formed by scattered single cells alternating with macrophages. "Spheres" with translucent centers contain multiple layers of viable tumor cells that shed single cells and may be more clinically aggressive. "Cloud" seeds are mostly composed of necrotic material, explaining their lack of therapeutic response. Pretreated eyes showed tumor seeds morphologically similar to untreated eyes. Knowledge of the underlying histopathology of vitreous seed types is a fundamental component of classification and may aid in understanding clinical response to treatment. (C) 2017 by the American Academy of Ophthalmology