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Cytopathology. 2019 Jul;30(4):385-392. doi: 10.1111/cyt.12711. Epub 2019 May 23.

Cytological diagnosis of vitreoretinal lymphomas: A case series.

Author information

1
Ophthalmology Department, CHU, Purpan University Hospital, Toulouse, France.
2
Ophthalmology Department, CHU, Caen, France.
3
Normandie University, UNICAEN, CHU de Caen Normandie, Unité de recherche, UMR-S 1075 INSERM-UNICAEN, Caen, France.
4
Pathology and Cytology Department, CHU, Institut Universitaire du Cancer-Oncopole, University Hospital, Toulouse, France.
5
Hematology Department, CHU, Institut Universitaire du Cancer-Oncopole, University Hospital, Toulouse, France.
6
Pathology Department, CHU, Caen, France.

Abstract

OBJECTIVE:

To assess the cytological diagnosis and follow-up of patients suffering from vitreoretinal lymphoma (VRL) diagnosed in our institution.

METHODS AND RESULTS:

From January 2010 to June 2017, we collected 15 patients with VRL. Twelve patients had diffuse large B-cell lymphoma (DLBCL); of these, 11 had primary central nervous system (CNS) DLBCL, one had ocular localisation of follicular lymphoma, one had extranodal NK/T-cell nasal type lymphoma and one had chronic lymphocytic leukaemia. The results of the cytological examination (cell morphology and immunocytochemistry) of the vitreous fluid were available for 9/15 VRL. The interleukin-10/-6 ratio was >1 in eight of 12 DLBCL. Molecular testing was useful in 6/15 cases (clonality evaluation or MYD88 L265P mutation testing). Eight out of 11 primary CNS DLBCL patients had CNS involvement, with 22-month progression-free survival. In our series, only two out of 11 CNS DLBCL patients died of disease after 2 and 5 years, respectively.

CONCLUSIONS:

The short delay to assert the diagnosis of VRL could explain the quite good prognosis in our series, which highlights the need to consider a diagnosis of DLBCL as first step. The cytological features, as a reliable way to identify VRL, must always guide the choice of techniques for further investigations given the small amount of vitreous fluid available for analysis.

KEYWORDS:

cytology; diagnosis; lymphoma; prognosis; retina; vitreoretinal

PMID:
31033057
DOI:
10.1111/cyt.12711

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