More Accurate Diagnosis of Vitreoretinal Lymphoma Using a Combination of Diagnostic Test Results: A Prospective Observational Study

Tanaka, Rie; Kaburaki, Toshikatsu; Taoka, Kazuki; Karakawa, Ayako; Tsuji, Hideki; Nishikawa, Masako; Yatomi, Yutaka; Shinozaki‐Ushiku, Aya; Ushiku, Tetsuo; Araki, Fumiyuki

doi:10.1080/09273948.2021.1873394

Cited by 16 publications

(11 citation statements)

References 37 publications

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“… 3 Other authors have assessed cytology, AIGHR, IL-10/IL-6 ratio, and clonal B-cells on flow cytometry and concluded that malignant cytology or positive results for two or more of four tests may be adequate for VRL diagnosis. 4 In our case, AIGHR and cytology were positive and met this criterion. It may be possible to supplement the detection sensitivity by collecting multiple biopsy materials, such as vitreous humor and subretinal fluid, and performing multiple tests.…”

Section: Discussionsupporting

confidence: 64%

A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy

Inami¹,

Shibuya²,

Kumagai³

et al. 2022

IMCRJ

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Section: Discussionsupporting

confidence: 64%

A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy

Inami¹,

Shibuya²,

Kumagai³

et al. 2022

IMCRJ

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“…IOL represents a challenging diagnosis requiring a thorough diagnostic workup as part of a multidisciplinary approach. Although cytopathology plays a crucial role in diagnosing IOL, additional methods including molecular genetics or flow cytometry have increasingly been applied in these settings [ 7 , 21 ]. We propose a comprehensive diagnostic algorithm including cytopathology, ddPCR, flow cytometry and imaging.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Laboratory Diagnostic Workup for Patients with Suspected Intraocular Lymphoma including Flow Cytometry, Molecular Genetics and Cytopathology

et al. 2022

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Background: Intraocular lymphoma (IOL) presents a real challenge in daily diagnostics. Cyto- and/or histopathology of vitreous body represent the diagnostic cornerstones. Yet, false negative results remain common. Therefore, we analyzed the diagnostic significance of flow cytometry (FC) within the workup algorithm of IOL and compared its sensitivity with the results obtained from routine cytopathology and molecular genetics; Methods: Seven patients undergoing vitrectomy due to suspected IOL were investigated by FC and parallel cytopathology and, if available, digital droplet PCR (ddPCR) for MYD88 L265P; Results: Four out of seven patients were finally diagnosed with IOL. Among the IOL patients, cytopathology confirmed the presence of lymphoma cells in only two cases. In contrast, FC was positive for IOL in all four cases, and FC additionally confirmed the lack of IOL in the remaining patients. In IOL patients diagnosed by FC and with available ddPCR, the diagnosis of IOL was confirmed by the presence of the MYD88 L265P mutation in all three patients; Conclusions: The combination with FC was superior to cytopathology alone in the diagnostic work-up of IOL, and it showed an excellent correlation with ddPCR results. A comprehensive diagnostic panel consisting of cytopathology, FC and molecular genetics should be considered for the work-up of suspected IOL.

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“…Identifying lymphoma cells in a vitreous specimen is key to the diagnosis of VRL. However, the diagnostic rate of VRL for vitreous cytology is 45–55% [ 11 , 18 ]. The reasons for such low detection rates may include the following: (1) lymphoma cells may not be detected in the samples obtained through vitreous tapping or diagnostic vitrectomy and (2) the vitreous specimens may be contaminated by other cellular structures, such as reactive T lymphocytes, necrotic cells, debris, and fibrin [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cytokine analysis can be used for VRL diagnosis; the amount of IL-10 derived from tumor cells can be measured and used to calculate the IL-10/IL-6 ratio. As a diagnostic biomarker for VRL, this ratio has a sensitivity of 81–92% and a specificity of approximately 100% [ 11 , 13 , 18 , 19 , 20 , 21 , 22 ]. IGH/IGK gene rearrangement in B-cell lymphomas is also an important diagnostic tool for VRL; it has a sensitivity of 46–96% and a specificity of 85–100% [ 11 , 18 , 19 , 20 , 21 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Vitreous Cytology in Patients with Vitreoretinal Lymphoma

Lee

Nahm

et al. 2022

JCM

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(1) Background: To determine the diagnostic value of vitreous cytology in patients with vitreoretinal lymphoma (VRL) and evaluate its diagnostic accuracy relative to that of other diagnostic tests. (2) Methods: In total, 38 eyes from 38 patients with VRL who underwent diagnostic vitrectomy and were followed up for at least 6 months were analyzed. The clinical manifestations and VRL diagnostic rates for all diagnostic tests were determined. (3) Results: The presence of vitreous cells/opacity was the most common ophthalmic finding (97.4%), followed by sub-retinal pigment epithelial infiltration (65.8%) and retinal hemorrhage (21.1%). The VRL diagnostic rates were 89.3% for interleukin (IL)-10 levels > 50 pg/mL; 82.1% for IL-10/IL-6 ratios > 1; 60.0% and 63.3% for immunoglobulin heavy chain and kappa light chain clonality assays, respectively; and 44.4% for vitreous cytology. The VRL diagnostic rate for vitreous cytology was significantly lower in the steroid pretreatment group than in the non-steroid pretreatment group (p = 0.007). (4) Conclusions: The VRL detection rate for vitreous cytology was lower than that for the other tests, especially in patients who received steroid pretreatment. These findings suggest that even if vitreous cytology findings are negative, other tests and characteristic fundus findings should be evaluated to confirm VRL diagnosis.

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More Accurate Diagnosis of Vitreoretinal Lymphoma Using a Combination of Diagnostic Test Results: A Prospective Observational Study

Cited by 16 publications

References 37 publications

A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy

A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy

Comprehensive Laboratory Diagnostic Workup for Patients with Suspected Intraocular Lymphoma including Flow Cytometry, Molecular Genetics and Cytopathology

Diagnostic Accuracy of Vitreous Cytology in Patients with Vitreoretinal Lymphoma

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