SUBRETINAL LAVAGE DURING DIAGNOSTIC VITRECTOMY: AN ADJUNCTIVE TECHNIQUE FOR CELL SAMPLING IN SUSPECTED VITREORETINAL LYMPHOMA.
Lorenzo Iuliano, Alessandro Marchese, Elisabetta Miserocchi et al.
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Case in brief
In patients with suspected vitreoretinal lymphoma and predominant subretinal involvement, standard vitreous sampling may have limited sensitivity. During diagnostic vitrectomy, clinicians injected 0.1 to 0.3 mL of balanced saline into the subretinal space, then manually aspirated the resulting cellular suspension with an extendable soft needle. The procedure was completed without complications in three patients and yielded approximately 0.3 mL of lymphoma cell-enriched fluid in each. Cytology identified CD20-positive B lymphocytes and the MYD88 L265P mutation in all three; concurrent vitreous cytology was positive in two.
What made this case unusual
Subretinal lavage provided diagnostic material in all three cases, including the patient whose concurrent vitreous cytology was negative, addressing the sampling challenge of predominant subretinal infiltration.
Diagnostic / clinical pearl
When vitreoretinal lymphoma predominantly involves the subretinal space, subretinal lavage during diagnostic vitrectomy may provide complementary cellular material for cytology and molecular testing.