Davis J L, Solomon D, Nussenblatt R B, Palestine A G, Chan C C
Laboratory of Immunology, National Eye Institute, Bethesda, MD 20892.
Ophthalmology. 1992 Feb;99(2):250-6. doi: 10.1016/s0161-6420(92)31984-0.
Diagnostic vitrectomy is often performed because of suspected infection or malignancy. Giemsa, Gram, and Papanicolaou stains are used routinely to identify the components in the vitreous. Immunocytochemical staining of cellular components of vitreous specimens has the potential to significantly increase the amount of useful information that can be gained from histopathologic study. Vitreous specimens from 14 patients undergoing diagnostic or therapeutic vitrectomy for infection, suspected primary intraocular lymphoma, or uveitis were examined by immunocytochemical staining using monoclonal antibodies specific for leukocyte subclass antigens and immunoglobulin. The three classes of disorders showed characteristic patterns of staining, which were useful in confirming microbiologic and clinical diagnoses. Infections showed more pronounced neutrophils and macrophages, primary intraocular lymphomas demonstrated light chain restriction of the malignant B lymphocytes, and uveitis was characterized by the predominance of T lymphocytes. The routine use of immunocytochemical staining is recommended to characterize cellular infiltrates and increase the diagnostic yield from vitrectomy specimens.
诊断性玻璃体切除术通常因怀疑感染或恶性肿瘤而进行。吉姆萨染色、革兰氏染色和巴氏染色常规用于识别玻璃体中的成分。玻璃体标本细胞成分的免疫细胞化学染色有可能显著增加从组织病理学研究中获得的有用信息量。对14例因感染、疑似原发性眼内淋巴瘤或葡萄膜炎接受诊断性或治疗性玻璃体切除术的患者的玻璃体标本，使用针对白细胞亚类抗原和免疫球蛋白的单克隆抗体进行免疫细胞化学染色检查。这三类疾病显示出特征性的染色模式，有助于确诊微生物学和临床诊断。感染表现为更明显的中性粒细胞和巨噬细胞，原发性眼内淋巴瘤表现为恶性B淋巴细胞的轻链限制，葡萄膜炎的特征是T淋巴细胞占优势。建议常规使用免疫细胞化学染色来鉴定细胞浸润并提高玻璃体切除标本的诊断率。
