Anterior chamber paracentesis cytology (cytospin technique) for the diagnosis of intraocular lymphoma

• Published in: British journal of ophthalmology Vol. 90; no. 6; pp. 690 - 692
• Main Authors: Finger, P T, Papp, C, Latkany, P, Kurli, M, Iacob, C E
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01-06-2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Aged; Aged, 80 and over; Alcohol; Anterior Chamber; Biological and medical sciences; Biopsy; Biopsy, Needle - methods; Cataracts; Cellular biology; cerebrospinal fluid; Chemotherapy; Clinical Science - Scientific Report; computed tomography; CSF; Cytokines; cytology; cytospin; Diagnosis, Differential; EBRT; Endophthalmitis - diagnosis; external beam radiation therapy; eye; Eye Neoplasms - diagnosis; Female; fine needle aspiration biopsy; Flow cytometry; FNAB; Gram-Positive Bacterial Infections - diagnosis; Health Insurance Portability & Accountability Act 1996-US; Hematologic and hematopoietic diseases; Humans; keratoprecipitates; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphocytes; Lymphoma; Lymphoma, Non-Hodgkin - diagnosis; magnetic resonance imaging; Male; Medical imaging; Medical sciences; Middle Aged; Miscellaneous; MRI; Nervous system; NMR; Nuclear magnetic resonance; Ophthalmology; Paracentesis - methods; Patients; Propionibacterium; Propionibacterium acnes - isolation & purification; Studies; Ultrasonic imaging; Intraocular; Cytology; Malignant hemopathy; Lymphoma; Tympanotomy; Treatment; Surgery; Lymphoproliferative syndrome; Anterior chamber; Diagnosis; Ophthalmology; Technique; Paracentesis
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.2005.087346

Aim: To report on the diagnosis of intraocular lymphoma by aqueous cytology. Methods: Four patients suspected of having intraocular lymphoma were evaluated by anterior chamber (AC) paracentesis with cytology (cytospin technique). All had a history of non-ocular lymphoma and presented with at least one plus anterior chamber cells despite intensive glucocorticoid therapy. A 25 gauge needle was inserted through clear cornea (bevel up), over the iris stroma, so as to drain the AC. The aqueous humour was sent for cytopathology (cytospin technique), culture, and sensitivity tests. Results: All procedures were diagnostic. Three were lymphoma and the fourth was culture positive for Propionibacterium endophthalmitis. No secondary glaucoma, hyphaema, cataract or infections were related to AC paracentesis. Conclusions: In this series, AC aspiration cytology enhanced by the cytospin technique was an effective, minimally invasive alternative to vitrectomy based biopsy. This technique should be considered to rule in the diagnosis of intraocular lymphoma in selected cases with cells in the anterior chamber.