Diagnostic efficacy of cell block method for vitreoretinal lymphoma.
Diagnostic efficacy of cell block method for vitreoretinal lymphoma.
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DOI：
10.1186/s13000-016-0479-1
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发表时间：
2016-03-17
影响因子：
2.6
通讯作者：
Ishida S
中科院分区：
文献类型：
--
作者：
Kase S;Namba K;Iwata D;Mizuuchi K;Kitaichi N;Tagawa Y;Okada-Kanno H;Matsuno Y;Ishida S
玻璃体视网膜淋巴瘤（VRL）是一种危及生命和视力的疾病。本研究的目的是分析细胞块法诊断VRL的有效性。本研究入组了12例VRL患者的16只眼和4例表现为玻璃体混浊的特发性葡萄膜炎患者的4只眼。在微切口玻璃体切除术期间分离未稀释的玻璃体和稀释的液体。在19只眼中，从含有破碎玻璃体的稀释液中制备细胞块标本。然后将这些标本提交进行HE染色以及使用针对B细胞标志物CD 20、T细胞标志物CD 3和细胞增殖标志物Ki 67的抗体进行免疫细胞学分析。对14只VRL患眼进行常规涂片细胞学检查，使用未稀释的玻璃体样本。VRL的诊断是基于细胞学检查、玻璃体白细胞介素（IL）-10和IL-6浓度以及免疫球蛋白重链基因重排分析的结果。15例VRL细胞块标本中14例（阳性率93.3%）检出非典型淋巴样细胞，而常规涂片细胞学检查中5例（阳性率35.7%）检出非典型淋巴样细胞。非典型淋巴样细胞呈CD 20和Ki 67免疫反应性。7份细胞块标本为涂片细胞学阴性和细胞块阳性。细胞块法显示任何特发性葡萄膜炎患者均无非典型淋巴样细胞。使用稀释的玻璃体液的细胞块标本表现出较高的诊断敏感性和较低的假阳性率的VRL的细胞学诊断。细胞块法有助于VRL和伴有玻璃体混浊的特发性葡萄膜炎的明确区分。本文的在线版本（doi：10.1186/s13000-016-0479-1）包含补充材料，可供授权用户使用。
Vitreoretinal lymphoma (VRL) is a life- and sight-threatening disorder. The aim of this study was to analyze the usefulness of the cell block method for diagnosis of VRL. Sixteen eyes in 12 patients with VRL, and 4 eyes in 4 patients with idiopathic uveitis presenting with vitreous opacity were enrolled in this study. Both undiluted vitreous and diluted fluids were isolated during micro-incision vitrectomy. Cell block specimens were prepared in 19 eyes from diluted fluid containing shredding vitreous. These specimens were then submitted for HE staining as well as immunocytological analyses with antibodies against the B-cell marker CD20, the T-cell marker CD3, and cell proliferation marker Ki67. Conventional smear cytology was applied in 14 eyes with VRL using undiluted vitreous samples. The diagnosis of VRL was made based on the results of cytology, concentrations of interleukin (IL)-10 and IL-6 in undiluted vitreous, and immunoglobulin heavy chain gene rearrangement analysis. Atypical lymphoid cells were identified in 14 out of 15 cell block specimens of VRL (positive rate: 93.3 %), but in 5 out of 14 eyes in conventional smear cytology (positive rate: 35.7 %). Atypical lymphoid cells showed immunoreactivity for CD20 and Ki67. Seven cell block specimens were smear cytology-negative and cell block-positive. The cell block method showed no atypical lymphoid cells in any patient with idiopathic uveitis. Cell block specimens using diluted vitreous fluid demonstrated a high diagnostic sensitivity and a low pseudo-positive rate for the cytological diagnosis of VRL. The cell block method contributed to clear differentiation between VRL and idiopathic uveitis with vitreous opacity. The online version of this article (doi:10.1186/s13000-016-0479-1) contains supplementary material, which is available to authorized users.