Relevance of Chorioretinal Biopsy in Primary Intraocular Lymphoma (PIOL)
Foerster A. M. H.1, Rössler G. F.1, Walter P.1, Thumann G.1, Coupland S. E.2, Kirchhof B.1
1Center of Ophthalmology, University of Cologne; 2Institute of Pathology, UKBF, Free University Berlin
Purpose: PIOL is a highly malignant non-Hodgkin´s lymphoma, usually of B-cell type, which falls under the differential diagnosis of uveitis. The diagnosis can be confirmed by cytological examination of a vitrectomy specimen and/or with the aid of histological investigation of a chorioretinal biopsy taken via a pars plana vitrectomy (ppv).
Method: Through a standard ppv a 2 x 2 mm chorioretinal biopsy was excised in 5 patients after light coagulation. The specimen was fixed in 4%-buffered formalin and examined using conventional and immunohistological stains. A vitreal aspiration for cytological investigation was performed in the same surgical procedure in all patients. This unfixed specimen was centrifuged and examined using both conventional and immunocytological stains.
Results: In 3 of 5 cases the diagnosis of PIOL was established through the histological examination of the chorioretinal biopsy. In 2 patients, the lymphoma was subtyped as diffuse large cell B-cell lymphoma; in the third patient, an intraocular manifestation of a systemic B-CLL was established. Cytological examinations demonstrated neoplastic cells in 2 cases; the vitrectomy specimen of the third patient was limited in diagnostic evaluation due to
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