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Abstract
Abstract
Transretinal Biopsy in Diagnosis of Primary Intraocular Lymphoma (PIOL)
Vij O.1, Bornfeld N.1, Coupland S.2
1Dept. of Ophthalmology, University of Essen; 2Dept. of Pathology, University Hospital Benjamin Franklin, FU Berlin
Purpose: Diagnosis of primary intraocular lymphoma indicates a cytological examination due to frequently variable clinical course and broad spectrum of differential diagnosis. Biopsy methods should guarantee a minimum of surgical risks with cytological irreproachable results. Transscleral biopsy and fine needle aspiration biopsy are established. Vitreous biopsy in PIOL is often limited by inconclusive cytopathologic diagnosis caused by inadequate sampling. 4 cases are presented, all underwent previous vitreous biopsy without conclusive result, cythopathologic examination verified PIOL after transretinal biopsy of elevated subretinal lesions.
Method: 4 female patients, mean age 60 years, with subretinal lesions suspicious for PIOL showed nondiagnostic vitreous biopsy. Core vitrectomy, retinotomy, transretinal biopsy with ocutome, injection of SF6, in addition standardized cytopathologic analysis was performed without complications. In 1 patient transretinal biopsy followed unconclusive vitreous biopsy after 2 years in the contralateral eye.
Results: In 3 patients diagnosis of B-cell, in 1 case of T-cell non-Hodgkin type lymphoma was made. CNS manifestation was found in 2 patients. Chemotherapy in 3 patients, combined radiation and chemotherapy in 1 patient resulted in tumour regression.