Intraocular lymphoma: diagnostic approach and immunophenotypic findings in vitrectomy specimens.
BACKGROUND
Diagnosis and classification of primary intraocular lymphoma can be challenging because of the sparse cellularity of the vitreous specimens.


OBJECTIVE
To classify and clinically correlate intraocular lymphoma according to the World Health Organization (WHO) classification by using vitrectomy specimens.


METHODS
Clinical history, cytologic preparations, flow cytometry reports, and outcome of 16 patients diagnosed with intraocular lymphoma were reviewed.


RESULTS
The study group included 10 women and 6 men. The mean age of the patients was 63 years (range, 19-79 years). Eleven patients had central nervous system involvement and 6 patients had systemic involvement. All cases were adequately diagnosed and classified according to the WHO classification by using combination of cytologic preparations and 4-color flow cytometry with a limited panel of antibodies to CD19, CD20, CD5, CD10, and kappa and lambda light chains. The cases included 9 primary diffuse large B-cell lymphomas of the CNS type; 2 diffuse large B-cell lymphomas, not otherwise specified; 1 extranodal, low-grade, marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT); 1 precursor B-lymphoblastic lymphoma; and 3 peripheral T-cell lymphomas, not otherwise specified. Of note, all 11 cases of diffuse large B-cell lymphoma were CD10-. All the patients received systemic chemotherapy and radiation therapy. Only 4 patients were free of disease at last follow-up (range, 18 months to 8 years), with severe visual loss.


CONCLUSIONS
Intraocular lymphoma cases can be adequately classified according to the WHO classification. Diffuse large B-cell lymphoma, CD10- and most likely of non-germinal center B-cell-like subgroup, is the most common subtype of non-Hodgkin lymphoma in this site, in contrast to ocular adnexal lymphoma for which MALT lymphoma is the most common subtype.
Raparia
Kirtee
K
Department of Pathology, The Methodist Hospital, 6565 Fannin Street, Houston, TX 77030, USA.
Chang
Chung-Che Jeff
CC
Chévez-Barrios
Patricia
P
D000328:Adult; D000368:Aged; D003581:Cytodiagnosis / Q000379:methods; D005134:Eye Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D018442:Lymphoma, B-Cell, Marginal Zone / Q000145:classification / Q000175:diagnosis / Q000601:surgery; D016403:Lymphoma, Large B-Cell, Diffuse / Q000145:classification / Q000175:diagnosis / Q000601:surgery; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013781:Texas / Q000453:epidemiology; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000473:pathology*; D014944:World Health Organization; D055815:Young Adult