Immunocytochemical diagnosis as inflammation by vitrectomy cell blocks in patients with vitreous opacity

Toshihiko Matsuo, Kouichi Ichimura

Research output: Contribution to journalArticle

10 Citations (Scopus)

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 hematoxylineosin 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. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish
Pages (from-to)827-837
Number of pages11
JournalOphthalmology
Volume119
Issue number4
DOIs
Publication statusPublished - Apr 2012

Fingerprint

Vitrectomy
Inflammation
Lymphoma
Histiocytes
Macrophages
Immunohistochemistry
Uveomeningoencephalitic Syndrome
T-Lymphocytes
Epithelioid Cells
Disclosure
B-Cell Lymphoma
Giant Cells
Sarcoidosis
Centrifugation
Eosinophils
Paraffin
Neutrophils
B-Lymphocytes
Outcome Assessment (Health Care)
Lymphocytes

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Immunocytochemical diagnosis as inflammation by vitrectomy cell blocks in patients with vitreous opacity. / Matsuo, Toshihiko; Ichimura, Kouichi.

In: Ophthalmology, Vol. 119, No. 4, 04.2012, p. 827-837.

Research output: Contribution to journalArticle

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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 hematoxylineosin 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. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.",
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