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Valerie A. White, MD, FRCPC; Randy D. Gascoyne, MD, FRCPC; Katherine E. Paton, MD, FRCSC

Arch Ophthalmol. 1999;117:761-765.

Objective  To determine whether the polymerase chain reaction for B- and T-cell gene rearrangements could be applied to vitreous specimens to aid in the diagnosis of intraocular lymphoma.

Methods  Vitreous washing specimens from 4 patients were received in balanced saline solution and centrifuged, and a portion of the pellet was used to make routine cytospins. The remainder was used to make a crude extract of DNA that was amplified for immunoglobulin heavy chain and T-cell receptor gene rearrangements and the 14;18 translocation by polymerase chain reaction.

Results  One patient had 2 specimens 2 years apart. In each, there was an identical band corresponding to the minor cluster region breakpoint of the bcl-2 oncogene, indicating the presence of a 14;18 translocation. One patient showed an immunoglobulin heavy chain gene rearrangement indicating a B-cell lymphoma. Two patients showed rearrangements of the T-cell receptor gene, indicating the presence of a T-cell lymphoma.

Conclusions and Clinical Relevance  Vitreous washing specimens can be used successfully to detect B- and T-cell gene rearrangements by polymerase chain reaction. This may be useful to confirm the diagnosis of intraocular large cell lymphoma in cases suggestive of the diagnosis. Prompt handling of the specimens is necessary to prevent degradation of the DNA.

From the Departments of Pathology (Drs White and Gascoyne) and Ophthalmology (Drs White and Paton), Vancouver Hospital and Health Sciences Centre; Department of Pathology, British Columbia Cancer Agency (Dr Gascoyne); and Departments of Pathology (Drs White and Gascoyne) and Ophthalmology (Dr Payton), University of British Columbia, Vancouver.

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