Spindle shaped pigmented cells in a vitreous fluid cytology

Abstract

Choroidal melanoma is a rare tumor, but it is the most common primary malignancy of the eye in adults. 3 Here, cytomorphological features corresponding to a cytological smear from a vitreous fluid, obtained by means of a vitrectomy, are described. A dark liquid from a 72-year-old male with an intraocular mass at the back end of the right ocular globe, and diagnosed by magnetic resonance, was sent to the laboratory. Cytospin smears for Papanicolaou staining and cell block for immunohistochemistry (IHC) were made. The Papanicolaou smear (Fig. C-1A) showed a high cellularity consisting of numerous spindle-shaped neoplastic cells which can be found isolated or arranged in clusters. These cells have elongated acidophilic cytoplasms containing brown pigment and enlarged nuclei (round-oval in shape) with anisokaryosis, binucleations, coarse chromatin, and prominent nucleoli. A careful observation, under oil immersion magnification, showed irregular nuclear membranes with indentations and oval nuclei with longitudinal nuclear grooves (Fig. C-1B). Moreover, in a very few cells, the presence of nuclear inclusions was observed (Fig. C-1C). IHC techniques were positive to S-100 and Melan-A. A cytological diagnosis of suspected choroidal melanoma was given. Subsequently, the histopathological examination of the enucleated eye confirmed the existence of a spindle cell choroidal melanoma.