|
|
 |
 |
104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
SA.13.04 Diagnosis of intraocular lymphoma Coupland S. E.
Dept. of Cellular and Molecular Pathology University of Liverpool Primary intraocular lymphoma (PIOL) is a rare non-Hodgkin B-cell lymphoma, involving the retina, the vitreous and/or the optic nerve. Most PIOL/PCNSL are diffuse large cell B-cell lymphomas (DLBCL), according to the updated World Health Organisation (WHO) Lymphoma classification, and, thus, are high-grade malignant lymphomas with a poor prognosis. Because of its’ slow, insidious onset and ability to simulate other conditions, both the clinical and histomorphological diagnosis of PIOL can be extremely difficult, and delay in diagnosis is common. The various presently used to establish the diagnosis of PIOL will be discussed. To establish the diagnosis of PIOL (or to exclude it), certain steps are required. Following its attainment, the vitreous biopsies should be sent (concentrated and diluted specimens) rapidly to the cytological laboratory, even if the specimens are fixed. The specimens should be marked “urgent”, and preferably the pathologist contacted before or on the sending of the specimen. Cytological examination of vitreous aspirates remains the first step in exclusion of neoplastic disease in patients with idiopathic uveitis. The next steps include immunophenotyping of the cells, either using immunocytology or flow cytometry. In the case of chorioretinal biopsies, these should be examined after embedding in paraffin, and stained for conventional and immunohistochemical stains. Should sufficient material (tissue or fluid) be available, additional clonality analyses using PCR should be considered. In this way, the diagnosis or exclusion of PIOL is made. The diagnosis of “reactive vitritis” in a clinically “unquiet” eye does not exclude the diagnosis of PIOL with absolute certainty. In occasional cases, repeat vitreous biopsies are required.
Zurück | Back
|
