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  • Title: Immunocytochemical diagnosis as inflammation by vitrectomy cell blocks in patients with vitreous opacity.
    Author: Matsuo T, Ichimura K.
    Journal: Ophthalmology; 2012 Apr; 119(4):827-37. PubMed ID: 22281090.
    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 hematoxylin-eosin 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.
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