Cytological diagnosis of vitreoretinal lymphomas: A case series
Résumé
Diffuse large B-cell lymphomas (DLBCL) are the most common of primary vitreoretinal lymphomas (VRL) and belong to the primary DLBCLs of the central nervous system (CNS). 1-3 CNS DLBCLs are rare and account for less than 1% of all non-Hodgkin lymphomas. 4 They are considered lymphomas of immune-privileged sites, tolerating the introduction of antigens without eliciting an immune response, similar to testes. 4,5 They are Epstein-Barr virus negative (except for in immune-compromised patients). 4,5 Their prognosis is classically considered poor, with 5-year overall survival of less than 25%. 6 The diagnosis of VRL is based on clinical data, imaging and analysis of vitreous fluid. 1 As a surgical biopsy is difficult to obtain due to the potential complications, the final diagnosis is mainly based on the cytological examination of vitreous samples. 7 The management of vitreous fluid to obtain a final diagnosis is challenging. We previously reported the practical management of vitreous samples to improve this diagnosis. 8 This method allows the assessment of interleukin (IL)-10/IL-6 ratio, cytological analysis, immunocytochemistry, and clonal rearrangement study. The difficulties are related to poor cellular content and cell preservation.