Lai Jie, Chen Kun, Shi Hui-Min, Zhuang Lin, Zhou Xian, Xiao Jian-Jiang, Li Yi, Chen Bo-Bin, Wang Qing-Ping
Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai 200040, China.
Department of Clinical Laboratory, Huashan Hospital, Fudan University, Shanghai 200040, China.
Int J Ophthalmol. 2019 Jun 18;12(6):1001-1007. doi: 10.18240/ijo.2019.06.20. eCollection 2019.
To evaluate the diagnostic value of B-scan ultrasound and explore the cytological characteristics of patients with vitreoretinal lymphoma (VRL) and primary central nervous system lymphoma (PCNSL).
The clinical data and pathologic specimens from patients with VRL diagnosed at the North Huashan Hospital from 2016 to 2017 were retrospectively reviewed. The patients were diagnosed by slit lamp ophthalmoscopy, B-scan ultrasound, cytology of the vitreous, which was obtained by vitrectomy, and cytokine measurements of interleukin (IL)-10 and IL-6.
Twenty-six eyes (19.4%) out of 134 eyes of 67 patients (47 men and 20 women) with PCNSL were diagnosed with VRL by B-scan ultrasound, and 14 eyes (10.4%) were diagnosed by slit lamp ophthalmoscopy. Twenty-four eyes (17.9%) of 17 patients were confirmed as having VRL with cytology. No difference in the association between intracranial lesion location and ocular involvement was found. VRL patients had higher levels of vitreous IL-10 and IL-10/IL-6 when compared with macular hole cases, but the difference was not statistically significant.
A total of 25.4% of the PCNSL patients had VRL, B-scan ultrasound examination had characteristic features and is recommended over slit lamp ophthalmoscopy for the screening diagnosis of PCNSL with intraocular involvement. Moreover, the cytological and immunohistochemical analyses performed after 25-gauge diagnostic vitrectomy were accurate diagnostic techniques.
评估B超的诊断价值，并探讨玻璃体视网膜淋巴瘤（VRL）和原发性中枢神经系统淋巴瘤（PCNSL）患者的细胞学特征。
回顾性分析2016年至2017年在复旦大学附属华山医院确诊的VRL患者的临床资料和病理标本。通过裂隙灯眼底检查、B超、玻璃体切除术获取的玻璃体细胞学检查以及白细胞介素（IL）-10和IL-6的细胞因子检测对患者进行诊断。
67例（47例男性，20例女性）PCNSL患者的134只眼中，26只眼（19.4%）通过B超诊断为VRL，14只眼（10.4%）通过裂隙灯眼底检查诊断为VRL。17例患者中的24只眼（17.9%）经细胞学检查确诊为VRL。颅内病变位置与眼部受累之间的关联无差异。与黄斑裂孔病例相比，VRL患者的玻璃体IL-10和IL-10/IL-6水平较高，但差异无统计学意义。
共有25.4%的PCNSL患者患有VRL，B超检查具有特征性表现，对于筛查诊断合并眼内受累的PCNSL，推荐使用B超而非裂隙灯眼底检查。此外，25G诊断性玻璃体切除术后进行的细胞学和免疫组织化学分析是准确的诊断技术。
