Use of the polymerase chain reaction to detect B- and T-cell gene rearrangements in vitreous specimens from patients with intraocular lymphoma

Objective: To determine whether the polymerase chain reaction for B- and T- cell gene rearrangements could be applied to vitreous specimens to aid in t he diagnosis of intraocular lymphoma. Methods: Vitreous washing specimens from 4 patients were received in balanc ed 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 g amma gene rearrangements and the 14;18 translocation by polymerase chain re action. Results: One patient had 2 specimens 2 years apart. In each, there was an i dentical band corresponding to the minor cluster region breakpoint of the b cl-2 oncogene, indicating the presence of a 14;18 translocation. One patien t showed an immunoglobulin heavy chain gene rearrangement indicating a B-ce ll lymphoma. Two patients showed rearrangements of the T-cell receptor gamm a 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 chai n reaction. This may be useful to confirm the diagnosis of intraocular larg e cell lymphoma in cases suggestive of the diagnosis. Prompt handling of th e specimens is necessary to prevent degradation of the DNA.