Cytology A Potentially Useful Modality for Diagnosis of Ocular Lesions
V Zayat, U Kapur, R Wafai, G Barkan, A Salhadar, EM Wojcik, S Mehrotra. Loyola University Medical Center, Maywood, IL
Background: Cytologic samples from the eye and its adnexa are a rarity in routine cytology practice. However accessibility and a wide diversity of lesions holds the potential for widespread utilization. In the present study we analyzed our archives for ocular cytology specimens to reflect on our diagnostic efficacy and potential utility of this modality.
Design: A retrospective review of our pathology database over the last ten years was performed to retrieve all cases of ocular cytology. Histologic correlates and clinical chart information were reviewed when available.
Results: There were a total of 24 specimens from16 patients including three Fine Needle Aspirations (FNA), five vitreous fluids (VF) and sixteen corneal/ conjunctival brush or scrapes (CB). The three FNA samples with diagnoses of lymphoma/ leukemia had histologic correlates reiterating the cytologic diagnoses. Of the five VF samples (three patients), one was positive for lymphoma, three were negative and one unsatisfactory. VF analysis had been predominantly performed for diagnosis and follow up of lymphoma. The sixteen CB samples from 11 patients had the following diagnoses rendered - negative cytology (9), mild dysplasia/ atypical squames (4) and severe dysplasia (3). Biopsy diagnosis available in the one patient with negative cytology was amyloid keratopathy. Samples from other patients with negative cytology had been submitted with clinical diagnoses of possible ocular surface neoplasia, viral infections, keratoconjunctivitis, evaluation of ocular surface extension of a neoplasm in the vicinity or follow-up of patients with known ocular surface dysplasia. Of the four specimens (three patients)with atypical squames/ mild dysplasia, one had corresponding histology and the other two were clinically followed up with therapeutic interventions. The three specimens (two patients) with severe dysplasia had histologic diagnoses of severe corneal intraepithelial neoplasia and squamous cell carcinoma. Thus FNA cytology had 100% concordance with histology and in no instance did ocular surface cytology miss dysplasia.
Conclusions: Our experience highlights the efficacy of cytology for diagnosis of ocular lesions, especially so for ocular surface dysplasia and explores its role as a potentially useful technique in routine practice. We feel that increasing awareness of this modality among pathologists and ophthalmologists might make it a widely accepted technique for triaging patients with accessible ocular lesions.
Wednesday, March 11, 2009 1:00 PM
Poster Session VI # 65, Wednesday Afternoon