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要約 目的:眼内悪性リンパ腫の鑑別診断のために硝子体生検を行った21例の報告。対象と方法:過去78か月間に硝子体生検を行った21例23眼を対象とした。術前診断は眼内悪性リンパ腫の疑い7例とぶどう膜炎14例である。採取した硝子体につき細胞診を行い,インターロイキン6と10(IL-6とIL-10)との濃度を測定した。結果:7例でIL-10値が773pg/ml以上,IL-6/IL-10比が10以上であり,眼内悪性リンパ腫と診断した。これら7例のうち,細胞診で2例のみがclass Ⅴであった。その他のぶどう膜炎では,IL-10値が188pg/ml以下で,IL-6/IL-10比が0.09以下であった。全例が細胞診ではclass ⅡまたはⅢであった。結論:生検による硝子体内のIL-6とIL-10の濃度測定は眼内悪性リンパ腫の鑑別診断に有用であった。
Abstract. Purpose:To report the outcome of vitreous biopsy for the diagnosis of intraocular malignant lymphoma in twenty-three eyes. Cases and Method:This retrospective study was made on 23 eyes of 21 cases who received vitreous biopsy in the past 78 months. Eight eyes were tentatively diagnosed with intraocular malignant lymphoma and 14 eyes with uveitis. The vitreous specimen was subjected to cytopathology and quantitation of interleukin(IL)6 and 10. Results:Seven eyes showed IL-10 value of 773 pg/ml or over and IL-6/IL-10 ratio of 10 or over. These 7 eyes were diagnosed with intraocular malignant lymphoma. Only 2 out of the 7 eyes were assigned to class Ⅴ by cytology. Eyes with uveitis showed IL-10 value less than 188 pg/ml and IL-6/IL-10 ratio less than 0.09. They were classified as class Ⅱ or Ⅲ cytologically. Conclusion:Quantitation of IL-6 and IL-10 levels in the vitreous was useful in the diagnosis of intraocular malignant lymphoma.
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