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 Table of Contents  
PHOTO ESSAY
Year : 2021  |  Volume : 1  |  Issue : 4  |  Page : 818-819

Usefulness and safety of liquid-based cytology in vitreous pathology following vitrectomy


1 Department of Ophthalmology and Visual Sciences, Yamagata University Faculty of Medecine, Yamagata, Japan
2 Department of Pathological Diagnostics, Yamagata University Faculty of Medecine, Yamagata, Japan

Date of Submission30-Dec-2020
Date of Acceptance27-Apr-2021
Date of Web Publication09-Oct-2021

Correspondence Address:
Dr. Koichi Nishitsuka
Department of Ophthalmology and Visual Sciences, Yamagata University Faculty of Medicine, Yamagata City, Yamagata
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3811_20

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  Abstract 


Keywords: Familial amyloid polyneuropathy, liquid-based cytology, malignant lymphoma, sarcoidosis, vitreous amyloidosis, vitreous opacity


How to cite this article:
Nishitsuka K, Kaneko Y, Narumi M, Namba H, Ohe R, Yamashita H. Usefulness and safety of liquid-based cytology in vitreous pathology following vitrectomy. Indian J Ophthalmol Case Rep 2021;1:818-9

How to cite this URL:
Nishitsuka K, Kaneko Y, Narumi M, Namba H, Ohe R, Yamashita H. Usefulness and safety of liquid-based cytology in vitreous pathology following vitrectomy. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Oct 26];1:818-9. Available from: https://www.ijoreports.in/text.asp?2021/1/4/818/327639



Liquid-based cytology (LBC) is the standard protocol for the analysis of liquid samples and was approved by the US Food and Drug Administration for the diagnosis of cervical cancer in 1996.[1] Compared with the direct smear method, LBC requires less sample material and allows for the analysis of liquid samples. In ophthalmology, this approach maximizes the utility of vitreous samples, which may be collected safely in small amounts (0.1–0.4 mL) during a standard core vitrectomy under perfusion.[2]

Cytological analysis was performed by LBC on a vitrectomy sample from an 81-year-old man suffering from vitreous opacities with a history of familial amyloid polyneuropathy. The results of the Congo red staining were positive and the characteristic apple-green birefringence was visible under polarized light [Figure 1]. This led to a diagnosis of vitreous amyloidosis.
Figure 1: Liquid-based cytology in vitreous amyloidosis. Positive Congo red staining and apple-green birefringence visualized using polarized light. (X10 magnification)

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LBC was conducted on a sample from a 75-year-old man suffering from steroid-resistant vitreous opacity in both eyes. Results indicated a high N/C ratio and the presence of chromatin-rich atypical lymphocytes after Papanicolaou staining [Figure 2]. These cells were positive for CD20 immunostaining [Figure 3]. This led to a diagnosis of primary intraocular malignant lymphoma.
Figure 2: Liquid-based cytology in primary intraocular malignant lymphoma. High N/C ratio and chromatin-rich atypical lymphocytes visualized using Papanicolaou staining (X40 magnification)

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Figure 3: Liquid-based cytology in primary intraocular malignant lymphoma. CD20-positive cells were identified by immunostaining (X40 magnification)

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LBC was carried out on a sample from a 32-year-old man with a history of sarcoidosis who suffered vision loss due to vitreous opacities. The results after Papanicolaou staining showed the presence of epithelioid histiocytes and multinucleated histiocytes [Figure 4], which led to a diagnosis of vitreous opacity due to sarcoidosis.
Figure 4: Liquid-based cytology in vitreous opacity due to sarcoidosis. Epithelioid and multinucleated histiocytes visualized using Papanicolaou staining (X40 magnification)

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  Discussion Top


The vitrectomy cell block technique is conventionally used in histological analysis. However, this technique frequently fails due to a variety of reasons.[3] In such situations, LBC would be very useful for histological analyses when the amount of sample specimen available is very small.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

This work was supported by JSPS KAKENHI Grant Number JP25462704.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Taoka H, Yamamoto Y, Sakurai N, Fukuda M, Asakawa Y, Kurasaki A, et al. Comparison of conventional and liquid-based cytology, and human papillomavirus testing using SurePath preparation in Japan. Hum Cell 2010;23:126-33.  Back to cited text no. 1
    
2.
Narumi M, Nishitsuka K, Yamakawa M, Yamashita H. A survey of vitreous cell components performed using liquid-based cytology. Acta Ophthalmol 2015;93:e386-90.  Back to cited text no. 2
    
3.
Ito T, Takeda A, Fujiwara K, Hasegawa E, Nakao S, Ohishi Y, et al. Risk factors for failure of vitrectomy cell block technique in cytological diagnosis of vitreoretinal lymphoma. Graefes Arch Clin Exp Ophthalmol 2019;257:1029-36.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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