Cytopathology of Vitreous Humor Samples in Routine Practice

Abstract

Objective: To describe findings in vitreous fluid samples in routine cytology practice. Study Design: The pathology archives from 1988 to 2008 at our institution were searched for vitreous samples. The slides were reviewed and clinical and follow-up information was obtained. Results: One hundred and eighty-two vitreous fluid samples from 166 patients were analyzed. Most of the samples had been collected for vitreous hemorrhage (75 cases). The second reason for vitreous sample cytological evaluation was an intraocular inflammatory process (55 cases). A specific cause of inflammation was found by combining clinical, microbiological and cytopathological findings in 19 cases, i.e. infection in 7, sarcoidosis in 3, retinal necrosis in 3, lens-induced endophthalmitis in 2, uveitis associated with systemic disease in 2, retrobulbar neuritis in 1 and sympathetic ophthalmia in 1. Among the 19 samples from 16 patients collected to rule out malignancy, 8 had a confirmed intraocular malignancy. Malignant cells were observed in 5 cases (3 lymphomas, 1 melanoma and 1 carcinoma). Undiagnosed malignancies included 2 lymphomas and 1 choroidal melanoma. Other samples were collected during surgery for retinal detachment and cataracts. Conclusions: In routine practice,cytology of the vitreous fluid is performed in many and varied situationsthat are most often nonneoplastic.In nonneoplastic cases, cytology is a useful adjunct to vitrectomy, in spite of its limitations.

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“…Inspired by the fact that vitreous cytopathology can easily detect trace amounts of cellular components, cytospins of the vitreous body were made to concentrate and observe tumor-associated immune cells. 60,61 Lymphocytes mixed with tumor cells were observed on Giemsa slides (Figure 3E). Then, the immunocytochemical analysis revealed the existence of tumor-infiltrating immune cells evidenced by CD3positive T cells (Figure 3F).…”

Potential Diagnosis of Vitreoretinal Lymphoma by Detection ofMYD88Mutation in Aqueous Humor With Ultrasensitive Droplet Digital Polymerase Chain Reaction

“…[4][5][6] Unfortunately, the presence of clonal cell populations is not limited to VRL, and more importantly, cytomorphologic evaluation often fails to detect lymphoma cells because of low cellularity or cell lysis during VF biopsies. [7][8][9] Although a vitreous tap or diagnostic vitrectomy is a relatively safe procedure, it can be associated with serious complications, such as vitreoretinal traction or hemorrhage, retinal detachment, and cataract formation in a later stage. 10 Aqueous humor (AH) sampling is a more safe and simple procedure with a lower risk of adverse reactions.…”

Cytologic analysis of vitreous fluids: A retrospective review of our 24 years of experience

“…27 cases were examined using a Cytospin concentration method. In a small subset of cases (7) where enough material was available both Thin Prep and Cytospin methods were incorporated in the analysis.…”

“…2 Predominantly bloody samples may be associated with prior retinal detachment or intraocular neoplasia. [6][7][8] Clinically relevant causes of acellular samples may be seen in association with asteroid hyalosis and amyloidosis. 9,10 In cases of diabetic retinopathy, vitreous samples may also display increased microparticles thought to be associated with cellular proliferative states.…”