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. 2014 Jun 18;7(3):577-81.
doi: 10.3980/j.issn.2222-3959.2014.03.33. eCollection 2014.

25-gauge transconjunctival diagnostic vitrectomy in suspected cases of intraocular lymphoma: a case series and review of the literature

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25-gauge transconjunctival diagnostic vitrectomy in suspected cases of intraocular lymphoma: a case series and review of the literature

Mozhgan Rezaei Kanavi et al. Int J Ophthalmol. .

Abstract

Aim: To report the cytology results of 25-gauge transconjunctival (25G-TSV) diagnostic vitrectomy in cases suspicious for intraocular lymphoma (IOL), and compare the results to those reported in the literature.

Methods: Clinical and cytopathological records of 18 vitreous biopsy specimens obtained via 25G-TSV diagnostic vitrectomy in 12 patients suspicious for IOL were reviewed retrospectively. A review of the literature in regards to the diagnostic yields of vitreous specimens obtained via 25-gauge and 20-gauge diagnostic vitrectomy in suspected cases of IOL was performed.

Results: Eighteen eyes from 12 patients with clinical suspicion of IOL underwent diagnostic 25G-TSV. The cytopathological investigations demonstrated IOL in 15 eyes (83.3%). Vitreous analysis was non-diagnostic in 3 eyes (16.7%).

Conclusion: Twenty-five-gauge diagnostic vitrectomy yields adequate sample for cytological evaluation of the vitreous in cases suspicious for IOL. The diagnostic results of the 25G-TSV in the current study are superior to those reported for 20-gauge vitrectomy but equivalent to those reported for 25G-TSV in the published literature.

Keywords: 20-gauge vitrectomy; 25-gauge vitrectomy; intraocular lymphoma.

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Figures

Figure 1
Figure 1. Photomicrographs of vitreous cytopathology in patients with clinical suspicion of IOL.
A: Diffuse large B-cell lymphoma in case 1 with aggregation of large pleomorphic mononuclear cells with irregular nuclei, prominent nucleoli and atypical mitosis in a vitreous cytospin preparation (Giemsa stain,×1000); B: Intraocular T cell lymphoma in case 7 with the presence of atypical lymphoid cells with mitosis, lack of immune-reactivity for CD20 (×400) and diffuse immune-reactivity (inset) for CD3 (×600); C: Nonspecific chronic inflammation in case 4 with the presence of small lymphocytes and no atypical features (hematoxylin & eosin,×400); D: Non-diagnostic and hypocellular vitreous specimen in case 8 with the presence of few red blood cells and few macrophage-like cells (hematoxylin & eosin, ×400).

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