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Updated: Jun 21, 2026
Cell-Free DNA Extraction of Vitreous and Aqueous Humor Specimens for Diagnosis and Monitoring of Vitreoretinal Lymphoma
Published on: January 12, 2024
Intraocular lymphoma: diagnostic approach and immunophenotypic findings in vitrectomy specimens
Kirtee Raparia1, Chung-Che Jeff Chang, Patricia Chévez-Barrios
1Department of Pathology, The Methodist Hospital, 6565 Fannin Street, Houston, TX 77030, USA.
Insights
Diagnosing intraocular lymphoma is challenging. Vitrectomy specimens and flow cytometry effectively classify lymphoma subtypes, with diffuse large B-cell lymphoma being most common.
Area of Science:
- Ophthalmology
- Hematology
- Oncology
Background:
- Primary intraocular lymphoma diagnosis is difficult due to sparse vitreous cellularity.
- Accurate classification is crucial for treatment and prognosis.
Purpose of the Study:
- To classify intraocular lymphoma using World Health Organization (WHO) criteria.
- To correlate clinical findings with lymphoma subtypes.
- To evaluate diagnostic methods for intraocular lymphoma.
Main Methods:
- Review of clinical history, cytologic preparations, and flow cytometry reports for 16 intraocular lymphoma patients.
- Utilized 4-color flow cytometry with a limited antibody panel (CD19, CD20, CD5, CD10, kappa/lambda light chains).
- Classified lymphomas according to the WHO classification system.
Main Results:
- 16 patients (10 women, 6 men; mean age 63) diagnosed with intraocular lymphoma.
- Common subtypes included diffuse large B-cell lymphoma (DLBCL, CD10-), MALT lymphoma, lymphoblastic lymphoma, and peripheral T-cell lymphoma.
- Central nervous system (11 patients) and systemic (6 patients) involvement were noted.
- All cases were successfully classified using cytology and flow cytometry.
Conclusions:
- Intraocular lymphoma can be reliably classified using the WHO system.
- CD10- DLBCL, likely non-germinal center type, is the most frequent intraocular lymphoma subtype.
- This contrasts with ocular adnexal lymphoma, where MALT lymphoma is more common.
Context:
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.
Design:
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.
