Cytologic specimens from the eye: A clinicopathologic study of 33 patients

Abstract

Cytologic specimens from the eye (CSE) (fine-needle aspirates and intraocular [vitrectomy] washings) are uncommon in most cytology practices. We reviewed our experience and diagnostic accuracy in lesions from this site over a 13-yr period. Thirty-three patients (12 males, 21 females, age 7-85 yr; mean 56 yr) were identified. Eighteen specimens were submitted to rule out malignancy. Of these, four CSE were positive, including melanoma (n = 1), large-cell lymphoma (n = 2), and carcinoma (n = 1). None of the 14 patients with negative cytology showed clinical evidence of malignancy over a 1-28-mo follow-up period (mean, 8.4 mo). Fourteen specimens were submitted to rule out infectious agents. Cytology material contained culture-proven organisms in one case each of Candida and Aspergillus. Of serology-confirmed specimens, four CSE failed to reveal toxoplasma, and three lacked herpes viral inclusions. One case each of culture-positive P. aches and C. albicans lacked the organisms in the CSE. Twelve specimens were submitted to rule out inflammatory lesions. CSE showed chronic inflammation (n = 5), acute and chronic inflammation (n = 1), macrophages (n = 5), and nonnecrotizing granulomas (n = 1). Of 3 patients with sarcoidosis, CSE contained mature lymphocytes in all 3 cases, but no granulomas. Although the numbers are small, there is greater sensitivity in the detection of malignancy than of infectious agents.