ASSOCIATION OF INTERLEUKIN-10 IN THE VITREOUS AND CEREBROSPINAL-FLUIDAND PRIMARY CENTRAL-NERVOUS-SYSTEM LYMPHOMA

Background: Diagnosis of primary central nervous system lymphoma (PCNS L) is usually made by identifying malignant lymphocytes in the brain, cerebrospinal fluid (CSF), or vitreous. However, these cells are few a nd friable, and misdiagnosis can occur, even in properly prepared spec imens. Recent data Suggest that levels of interleukin 10 (IL-10) are e levated in the serum and vitreous of patients with non-Hodgkin lymphom a; levels of interleukin 6 (IL-6) are elevated in the vitreous of pati ents with intraocular inflammation unrelated to a malignant neoplasm. We investigated whether PCNSL involving the vitreous or CSF is associa ted with elevated ratios of IL-10 to IL-6. Patients: Vitreous specimen s were obtained from 5 patients with PCNSL involving the eye and from 13 control patients with intraocular inflammation not related to a mal ignant neoplasm; CSF specimens were obtained from 11 patients with PCN SL. Results: Levels of IL-10 exceeded those of IL-6 in all 5 patients with intraocular lymphoma but in none of the 13 patients with uveitis (P<.001). In patients with PCNSL, levels of IL-10 exceeded those of IL -6 in 6 of 11 CSF samples with malignant cells compared with 7 of 53 s amples without malignant cells (P=.01). The calculated odds ratio (OR) suggests that the risk for malignant involvement of the CSF is about 8 times higher when IL-10 levels exceed IL-6 levels.Methods: Levels of IL-10 and IL-6 were determined by enzyme-linked immunosorbent assay i n both vitreous and CSF specimens. Conclusions: The occurrence of PCNS L in the eye was strongly associated with elevated vitreous levels of IL-10 relative to levels of IL-6. Moreover, among patients with diagno sed PCNSL, malignant cells were significantly more likely to be presen t in CSF when levels of IL-10 exceeded those of IL-6.