Cytopathologic findings of cell block materials from the vitreous: Diagnostic distinction between intraocular lymphoma and non-lymphomatous diseases
Cytopathologic findings of cell block materials from the vitreous: Diagnostic distinction between intraocular lymphoma and non-lymphomatous diseases
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DOI：
10.1111/pin.12551
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发表时间：
2017-07-01
影响因子：
2.2
通讯作者：
Matsuno, Yoshihiro
中科院分区：
文献类型：
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作者：
Kanno-Okada, Hiromi;Takakuwa, Emi;Matsuno, Yoshihiro
眼内淋巴瘤是一种罕见的肿瘤，只发生在眼睛和/或中枢神经系统。诊断眼内淋巴瘤是困难的，因为它的临床表现类似慢性葡萄膜炎。玻璃体的病理检查是眼内淋巴瘤的主要诊断工具之一，但由于细胞稀疏和标本变性，这是具有挑战性的。在这里，我们回顾了33种来自玻璃体灌注液的细胞阻断制剂，以检验细胞病理学结果对玻璃体样本鉴别诊断的意义。其中眼内淋巴瘤12例，非淋巴瘤21例。细胞学上，非淋巴瘤病例的玻璃体样本细胞密度低于淋巴瘤病例。感染性眼内炎患者的玻璃体材料显示明显的中性粒细胞浸润，结节病患者的材料显示小淋巴样细胞浸润，尤其是cd4阳性T细胞。另一方面，淋巴瘤患者细胞性较高，淋巴样细胞大、不规则、不典型，背景中坏死细胞较多，中性粒细胞浸润不明显。免疫细胞化学分析，12例淋巴瘤11例为b细胞表型，其余为T/ nk细胞表型。总之，仔细的细胞病理学检查或免疫细胞化学玻璃体物质有助于正确诊断眼内淋巴瘤。
Intraocular lymphoma is a rare neoplasm that occurs only in the eyes and/or central nervous system. Diagnosis of intraocular lymphoma is difficult because its clinical manifestations mimic chronic uveitis. Pathological examination of the vitreous is one of the main diagnostic tools for intraocular lymphoma, but this is challenging due to the sparse cellularity and specimen degeneration. Here, we reviewed 33 cell block preparations from vitreous perfusion fluid in order to examine the significance of cytopathological findings for differential diagnosis using vitreous samples. The cases comprised 12 intraocular lymphomas and 21 non-lymphomatous diseases. Cytologically, vitreous samples from non-lymphoma cases showed lower cellularity than the lymphoma cases. Whereas vitreous material from cases with infectious endophthalmitis showed prominent neutrophilic infiltration, material from sarcoidosis cases showed infiltration of small lymphoid cells, especially CD4-positive T cells. On the other hand, lymphoma cases showed higher cellularity, with large, irregular and atypical lymphoid cells, frequent necrotic cells in the background, and less pronounced neutrophil infiltration. Immunocytochemically, 11 of the 12 lymphoma cases were of the B-cell phenotype and the remaining case was of the T/NK-cell phenotype. In conclusion, careful cytopathological examination or immunocytochemistry of vitreous material facilitates appropriate diagnosis of intraocular lymphoma.