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Ataxia and vision loss: flow cytometric diagnosis of primary central nervous system lymphoma
  1. Mark T Cahill1,
  2. Mirela Stancu2,
  3. Jorge G Arroyo3
  1. 1Beetham Eye Institute, Joslin Diabetes Center, One Joslin Place, Harvard Medical School, Boston MA, USA and Division of Ophthalmology, Beth Israel Deaconess Medical Center, Division of Ophthalmology, Brigham and Women's Hospital, and the Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston MA, USA
  2. 2Department of Hematology, Beth Israel Deaconess Medical Center, Harvard Medical School, Brookline Avenue, Boston MA, USA
  3. 3Division of Ophthalmology, Beth Israel Deaconess Medical Center, Division of Ophthalmology, Brigham and Women's Hospital, and the Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston MA, USA
  1. Correspondence to: Jorge G Arroyo, MD, Department of Ophthalmology, Retina Service, 12th Floor, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA; jarroyo{at}caregroup.harvard.edu

https://doi.org/10.1136/bjo.86.2.246

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    Approximately 20% of patients with primary central nervous system lymphoma will have eye involvement, which often precedes diagnosis by a number of months.1–4 The diagnosis of intraocular and/or CNS lymphoma depends on histological evidence in tissue obtained from a CNS biopsy or cytological demonstration of malignant cells in the vitreous or cerebrospinal fluid (CSF).4

    Cytological differentiation of reactive lymphoid cells from well differentiated lymphoma using morphological characteristics depends on observer skill and the preservation of adequate numbers of cells.5 Immunocytochemical staining of cell surface antigens assists in this differentiation and can detect cell population monoclonality, a common feature of large B cell lymphomas.5 Cytofluorography or flow cytometry is a semiautomated method of immunocytochemistry which has some advantages over slide based immunocytochemistry including objective and quantitative data on cell surface markers.6,7

    We present a patient with ataxia and vision loss who was diagnosed with primary CNS lymphoma using cytofluorographic analysis of a vitreous biopsy specimen.

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