Cytologic findings in vitreous fluids. Analysis of 74 specimens.
OBJECTIVE
To review the cytologic findings of vitreous specimens and propose a simplified approach to them.


METHODS
Seventy-four vitreous specimens from 60 patients obtained either during a pars plana vitrectomy or by vitreous aspiration were reviewed. Clinical correlation was obtained on all patients.


RESULTS
Findings suggestive of a specific disorder were present in 30 specimens (41%); cytologic examination of the remaining 44 showed nonspecific changes. A lymphoproliferative disorder, the intraocular malignancy suspected most often in this series, was identified in eight specimens (11%). Large cell lymphomas were evident in 5 specimens, 2 specimens were suspicious for lymphoma, and 1 specimen was consistent with plasmacytoma. Twelve specimens (16%) contained hemorrhage. In rare instances, specific infectious agents, such as parasites (5%), bacteria (1%) and fungi (3%), could be identified. The diagnosis of viral infections required ancillary studies. Lens fragments were identified in four cases (5%), and a diagnosis of lens-induced endophthalmitis could be rendered in one case (1%). Changes consistent with sarcoidosis were present in 3% of cases.


CONCLUSIONS
Based on this experience with vitreous specimens submitted for clinical reasons, we found that they could be divided into three broad diagnostic categories: inflammation/infection (54 specimens/41 patients), hemorrhage (12 specimens/12 patients) and malignancy (8 specimens/7 patients).
Liu
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Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Klintworth
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GK
Dodd
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LG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001082:Aqueous Humor; D001409:Bacillus cereus; D002648:Child; D002675:Child, Preschool; D004804:Eosinophils / Q000473:pathology; D005128:Eye Diseases / Q000382:microbiology* / Q000473:pathology; D005134:Eye Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007908:Lens, Crystalline / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology; D009504:Neutrophils / Q000473:pathology; D010954:Plasmacytoma / Q000473:pathology; D017166:Toxocara canis; D014120:Toxocariasis / Q000473:pathology; D014822:Vitreous Body / Q000473:pathology*