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Author Spotlight: Advancing VRL Diagnosis Using Cell-Free DNA Extraction from Vitreous Humor
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Flow cytometry immunophenotyping of vitreous specimens does not contribute to diagnosis of lymphoma without

Colby A Cantu1, Cynthia L Green2, Thomas J Cummings1

  • 1Department of Pathology, Duke University Medical Center, Durham, North Carolina.

Diagnostic Cytopathology
|November 29, 2018
PubMed

Insights

Diagnostic vitrectomy with flow cytometry immunophenotyping (FCI) is valuable for detecting intraocular lymphoma. Absence of large lymphocytes on cytology predicts negative FCI results, suggesting FCI may not be needed in such cases.

Area of Science:

  • Ophthalmology
  • Hematology
  • Cytopathology

Background:

  • Diagnostic vitrectomy with flow cytometry immunophenotyping (FCI) is increasingly utilized for challenging cases.
  • Evaluating the combined utility of cytopathology and FCI in pars plana vitrectomy is crucial.
  • Identifying cytologic predictors of FCI outcomes can refine diagnostic indications.

Purpose of the Study:

  • To assess the diagnostic value of combined cytopathology and FCI in pars plana vitrectomy.
  • To identify cytologic features that predict flow cytometry immunophenotyping outcomes.
  • To establish clearer indications for using FCI in diagnostic vitrectomy.

Main Methods:

  • Retrospective analysis of 99 diagnostic pars plana vitrectomy specimens (2010-2016).
  • Evaluation of associations between cytologic features and FCI results.
  • Statistical analysis of cytologic findings and FCI outcomes.

Main Results:

  • Cytopathology evaluation was diagnostic in 39.4% of specimens.
  • FCI performed on 90.4% of lymphoma-indicated specimens showed abnormal lymphocytes in 13.6%.
  • Absence of large lymphocytes was the sole significant predictor of negative FCI (NPV=97.7%, OR=14.0, P=0.034).

Conclusions:

  • Diagnostic vitrectomy with cytopathology is valuable for intraocular lymphoma diagnosis.
  • Concomitant FCI is useful for confirming intraocular lymphoma.
  • Absence of large lymphocytes predicts negative FCI, potentially obviating its use.
Abstract

Keywords:
diagnostic pars plana vitrectomyflow cytometryintraocular lymphomavitreous humor cytopathology

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