Matsuo T, Ichimura K. Immunocytochemical diagnosis as inflammation by vitrectomy cell blocks in patients with vitreous opacity.
Ophthalmology 2012;
119:827-37. [PMID:
22281090 DOI:
10.1016/j.ophtha.2011.10.020]
[Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 10/14/2011] [Accepted: 10/14/2011] [Indexed: 11/26/2022] Open
Abstract
PURPOSE
To describe the clinical and cytopathologic characteristics in patients with vitreous opacity of unknown cause or preceding inflammation, diagnosed cytopathologically as inflammation.
DESIGN
Retrospective case series.
PARTICIPANTS
Forty-three consecutive patients (61 eyes) who underwent vitrectomy for vitreous opacity of unknown cause or preceding inflammation and were diagnosed cytopathologically with inflammation at one institution in 6 years from 2005 to 2010. During the same period, 11 consecutive patients with vitreous opacity of unknown cause were diagnosed cytopathologically with lymphoma (large B-cell lymphoma) and were excluded from the study.
METHODS
Cell blocks were made by centrifugation of vitrectomy fluid and embedded in paraffin for immunocytochemistry.
MAIN OUTCOME MEASURES
Cytopathologic and immunocytochemical diagnosis using vitrectomy cell blocks.
RESULTS
Histiocytes (macrophages), small lymphocytes, neutrophils, and eosinophils were predominant cells, with no atypical large cells on hematoxylin-eosin staining. Immunocytochemically, most predominant cells were CD68-positive histiocytes (macrophages), followed by CD3-positive T cells, but CD20- or CD79a-positive B cells were rarely present. Epithelioid cells, positive for CD68, were found in 4 patients with or without an established diagnosis of sarcoidosis, and giant multinucleated cells were found in 2 patients with suspected preceding self-limiting Vogt-Koyanagi-Harada disease, based on the presence of depigmented red fundi. Inflammation was diagnosed in 2 patients with vitreous opacity who had a preceding onset of brain lymphoma or systemic lymphoma.
CONCLUSIONS
The presence of macrophages, combined with small T lymphocytes, was a major sign in intravitreal inflammation, manifesting as vitreous opacity. A simple technique of cytopathology and immunocytochemistry, using vitrectomy cell blocks, can be performed in most pathology laboratories.
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