N Katai1, S Kuroiwa, K Fujimori, N Yoshimura. 1. Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Japan. eyekata@gipac.shinshu-u.ac.jp
Abstract
BACKGROUND: Cytopathological examinations have been used in the diagnosis of intraocular lymphoma. However, sometimes it is not easy to detect malignant cells in the biopsy specimens. We applied a method that identified monoclonal proliferation of B lymphocytes by using polymerase chain reaction (PCR) in the diagnosis of patients suspected to have intraocular B-cell lymphoma. METHODS: Three specimens of the diagnostic vitrectomy were studied by cytological examination and by PCR to amplify the complementary determining region (CDR3) of immunoglobulin heavy chain (IgH) gene. As a positive control, a biopsy specimen of an orbital lymphoma was examined; four vitrectomy specimens from patients with diabetic retinopathy, proliferative vitreo-retinopathy, acute retinal necrosis (ARN) and macular hole were negative controls. RESULTS: On cytologic examination, no malignant cells were found in three specimens: suspected intraocular lymphoma and one ARN. In contrast, a discrete band that reflected monoclonal proliferation of B lymphocytes was detected by PCR in specimens from two patients and the positive control. Vitrectomy specimens from the negative controls, including ARN, did not show a discrete band on PCR. CONCLUSIONS: Two cases of ocular malignant lymphoma were diagnosed by PCR identification of monoclonal proliferation of B lymphocytes. This method may be an additional diagnostic tool in the diagnosis of intraocular B-cell lymphoma.
BACKGROUND: Cytopathological examinations have been used in the diagnosis of intraocular lymphoma. However, sometimes it is not easy to detect malignant cells in the biopsy specimens. We applied a method that identified monoclonal proliferation of B lymphocytes by using polymerase chain reaction (PCR) in the diagnosis of patients suspected to have intraocular B-cell lymphoma. METHODS: Three specimens of the diagnostic vitrectomy were studied by cytological examination and by PCR to amplify the complementary determining region (CDR3) of immunoglobulin heavy chain (IgH) gene. As a positive control, a biopsy specimen of an orbital lymphoma was examined; four vitrectomy specimens from patients with diabetic retinopathy, proliferative vitreo-retinopathy, acute retinal necrosis (ARN) and macular hole were negative controls. RESULTS: On cytologic examination, no malignant cells were found in three specimens: suspected intraocular lymphoma and one ARN. In contrast, a discrete band that reflected monoclonal proliferation of B lymphocytes was detected by PCR in specimens from two patients and the positive control. Vitrectomy specimens from the negative controls, including ARN, did not show a discrete band on PCR. CONCLUSIONS: Two cases of ocular malignant lymphoma were diagnosed by PCR identification of monoclonal proliferation of B lymphocytes. This method may be an additional diagnostic tool in the diagnosis of intraocular B-cell lymphoma.
Authors: Sarah E Coupland; Nikolaos E Bechrakis; Gerasimos Anastassiou; Andreas M H Foerster; Arnd Heiligenhaus; Uwe Pleyer; Michael Hummel; Harald Stein Journal: Graefes Arch Clin Exp Ophthalmol Date: 2003-09-30 Impact factor: 3.117