Primary Intraocular Lymphoma

Karma, Alain; Willebrand, Eva O. von; Tommila, Petri; Paetau, Anders; Oskala, Pertti; Immonen, Ilkka

doi:10.1016/j.ophtha.2006.11.009

Cited by 49 publications

(7 citation statements)

References 31 publications

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“…The pathologist’s role is to accurately identify the malignant lymphoma cells on the basis of morphology, and then to assess the clonality using immunocytochemistry and molecular techniques like flow cytometry and PCR analysis. Morphologically, the typical lymphoma cells are large B-cell lymphoid cells with a scanty basophilic cytoplasm, an increased nucleus:cytoplasm ratio, with hypersegmented, multivariable-shaped nuclei, multiple nucleoli, and a coarse chromatin pattern 43,44,68,69. The correlation between pathological diagnosis and clinical diagnosis on long-term follow-up is as high as 96% 44.…”

Section: Biopsymentioning

confidence: 99%

<p>Primary vitreoretinal lymphoma: prevalence, impact, and management challenges</p>

Venkatesh¹,

Bavaharan²,

Mahendradas³

et al. 2019

OPTH

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Primary vitreoretinal lymphoma (PVRL) is a rare and potentially fatal intraocular malignancy. More than half of PVRL cases eventually involve the central nervous system (CNS). PVRL frequently masquerades as chronic uveitis. Advanced imaging tests, such as optical coherence tomography and fundus autofluorescence, have been applied in the diagnosis of PVRL. Histology and immunohistochemistry, in combination with molecular tests and IL-10 analysis, have been demonstrated as reliable in diagnosing PVRL. Mortality is high in patients with PVRL associated with CNS involvement, and relapses are common. The use of systemic chemotherapy in addition to the local therapies has proved to extend the mean survival time of these patients. Local therapies, including intravitreal injections of methotrexate and/or rituximab and low-dose radiotherapy to the eye, have been shown to be extremely effective in controlling intraocular lymphoma.

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Section: Biopsymentioning

confidence: 99%

<p>Primary vitreoretinal lymphoma: prevalence, impact, and management challenges</p>

Venkatesh¹,

Bavaharan²,

Mahendradas³

et al. 2019

OPTH

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“…Vitreous (humor) is usually obtained by pars plana vitrectomy, a surgical procedure performed under local or general anesthesia. Surgical instruments are introduced into the posterior segment of the eye, allowing the surgeon to cut and aspirate the viscous vitreous; undiluted or "dry" vitreous is most useful for testing, but any diluted material is also retained for analysis [97,98]. A vitreous "tap," with a 25-or 27-gauge needle, yields less vitreous and is not commonly used to obtain a specimen for diagnostic purposes.…”

Section: Ocular Fluid-and Tissue-based Diagnosticsmentioning

confidence: 99%

Vitreoretinal Lymphoma

Sobolewska

Zaguia

Goldstein

et al. 2021

Cancers

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Vitreoretinal lymphoma (VRL) is a rare variant of primary central nervous system lymphoma (PCNSL), mostly of diffuse large B cell lymphoma, which affects the retina and/or the vitreous with or without optic nerve involvement. The disease course is aggressive. Up to 90% of the patients develop central nervous system lymphoma within one year. The diagnosis of VRL is challenging due to nonspecific chronic and relapsing uveitis and is made by anterior chamber tab or vitreous aspirate biopsy. There is no established treatment protocol for VRL patients with bilateral involvement without CNS involvement. There are suggestions to use only intravitreal chemotherapy with methotrexate and/or rituximab. Alternatively, systemic high-dose MTX treatment or external beam radiotherapy is used. Further studies are needed to prove and confirm the prophylactic systemic therapy in preventing CNS involvement in limited VRL.

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“…Repeatedly negative sampling may necessitate a chorioretinal biopsy to be undertaken. Lymphoma cells are fragile and rapidly disintegrate, meaning that [30] obtaining an adequate vitreous sample requires special considerations and procedures [31]. Ideally, at least 2 mL of undiluted vitreous should be sampled, and the pathologist analysing the sample should be made aware to expect the sample and to analyse it, ideally within one hour of the procedure.…”

Section: Suspected Intraocular Lymphomamentioning

confidence: 99%

Vitreous Analysis in the Management of Uveitis

Damato

Angi

Romano

et al. 2012

Mediators of Inflammation

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A correct diagnosis of uveitis is often challenging, given the wide range of possible underlying conditions and the lack of typical phenotypes. Management decisions may be difficult in view of the risk of visual loss with either inappropriate or delayed therapy. Analysis of the vitreous may therefore be used to provide the clinician with valuable information. In this paper, we describe the main clinical situations in which vitreous sampling is indicated and provide some guidance to clinicians for tailoring their requests. These situations include suspected intraocular infection and suspected intraocular malignancy. We describe the principal tests carried out on vitreous samples, including cultures, polymerase chain reaction-based testing, and cytokine analysis. Limitations of the tests used are likely to become less as more advanced testing methods are introduced. The importance of selecting the appropriate investigations to support a clinical suspicion is emphasised, as is the interpretation of test results within a clinical context.

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Primary Intraocular Lymphoma

Cited by 49 publications

References 31 publications

<p>Primary vitreoretinal lymphoma: prevalence, impact, and management challenges</p>

<p>Primary vitreoretinal lymphoma: prevalence, impact, and management challenges</p>

Vitreoretinal Lymphoma

Vitreous Analysis in the Management of Uveitis

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