Artikel
Diagnostic approach in primary intraocular lymphoma by transretinal biopsy
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Autoren
Veröffentlicht: | 22. September 2004 |
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Gliederung
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Objective
Due to frequently variable clinical course and a broad spectrum of differential diagnosis in primary intraocular lymphoma a cytological examination is often indicated. Biopsy methods should guarantee a minimum of surgical risks with cytological irreproachable results. Vitreous biopsy in PIOL is often limited by inconclusive cytopathologic diagnosis caused by inadequate sampling. 5 cases are presented, in which previous vitreous biopsy result was not evident. After transretinal biopsy of elevated subretinal lesions cythopathologic examination verified PIOL.
Methods
5 female patients with a mean age of 66 years, showed nondiagnostic vitreous biopsy in subretinal lesions suspicious for PIOL. Biopsy with the ocutome was obtained by core vitrectomy and retinotomy. Standardized cytopathologic analysis was performed without complications. 1 patient underwent transretinal biopsy 2 years after inconclusive vitreous biopsy in the contralateral eye.
Results
In 4 patients the diagnosis of B-cell, in 1 case of T-cell non-Hodgkin type lymphoma was established. CNS manifestation was found in 2 patients, in one case the staging is not finished yet. Tumour regression was obtained by chemotherapy in 3 patients and combined radiation with chemotherapy in 1 patient. During an average follow-up of 13.5 months, one tumour recurrence occured in the same eye.
Conclusions
In suspicious cases for PIOL and inconclusive cytopathologic diagnosis due to inadequate vitreous biopsy a transretinal approach should be considered in elevated subretinal lesions. This method is safe and well manageable and seems to be superior to fine needle aspiration.