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. 2022 Mar 3;11(5):1391.
doi: 10.3390/jcm11051391.

Diagnostic Accuracy of Cell Block Preparations and Clinical Features Affecting It in Vitreoretinal Lymphoma

Satoru Kase  1 , Kenichi Namba  1 , Daiju Iwata  1 , Kazuomi Mizuuchi  1 , Kayo Suzuki  1 , Takako Ito  1 , Keitaro Hase  1 , Nobuyoshi Kitaichi  1   2 , Susumu Ishida  1
Affiliations

Diagnostic Accuracy of Cell Block Preparations and Clinical Features Affecting It in Vitreoretinal Lymphoma

Satoru Kase et al. J Clin Med. .

Abstract

Purpose: The purpose of this study was to examine the diagnostic accuracy of the cell block (CB) method and clinical features affecting it in patients with vitreoretinal lymphoma (VRL). Methods: This study enrolled 38 eyes in 33 VRL patients, and 7 eyes in 7 patients with idiopathic uveitis who underwent diagnostic vitrectomy. Medical records including the results of CB cytology, interleukin (IL)-10/-6 concentrations, and immunoglobulin heavy chain gene (IgH) rearrangement were retrospectively searched. Results: Patients with VRL comprised 16 women and 17 men, and the age of onset ranged from 44 to 85 years (mean: 70 years). CB preparations detected large malignant cells in 35 eyes (92%), whereas the other 3 VRL eyes were negative. Two of the latter three eyes showed subretinal infiltrates, which existed in 7 of 35 CB-positive eyes. Intravitreal IL-10 and -6 concentrations were 1866 ± 4088 pg/mL and 98 ± 139 pg/mL, respectively, and the rate of IL-10/-6 >1 was 86.9%. The presence of IgH monoclonality was 63.2%. In patients with uveitis, CB specimens revealed no atypical but small inflammatory cells. IL-6 concentration was 311.1 ± 240 pg/mL, whereas IL-10 was undetectable in six eyes, and the IL-negative rate was 85.7%. Six eyes (85.7%) with uveitis showed no IgH monoclonality. Conclusions: Diagnostic accuracy of CB preparations in VRL could achieve an equivalent outcome to IL ratio calculation and IgH monoclonality detection. The appearance of subretinal infiltrates may diminish the CB positivity.

Keywords: cell block preparations; optical coherence tomography; subretinal infiltrates; vitreoretinal lymphoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Representative case with vitreoretinal lymphoma showing positive cell block cytology. Fundus shows 2+ vitreal haze OD (A). The CB specimen shows large malignant cells in the vitreous (B) with CD20-positive cells (C) where CD3-positive small T cells are intermingled (D).
Figure 2
Figure 2
Representative case 1 with vitreoretinal lymphoma showing negative cell block cytology. Fundus shows 1+ vitreal haze and irregular subretinal infiltrates OD (A). OCT displays abnormal reflection between the RPE layer and Bruch’s membrane (B). The CB specimen shows no malignant cells in the vitreous (C), where CD3-positive small T cells are intermingled (D).
Figure 3
Figure 3
Representative case 1 after intravitreal methotrexate (IV-MTX) injection. After IV-MTX, the vitreal haze and subretinal infiltrates were resolved (A). Abnormal refection between the RPE layer and Bruch’s membrane disappeared following IV-MTX (B).
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