Clinical Report: Aqueous cytology may diagnose iris metastasis without biopsy

Overview

Aqueous humor cytology can diagnose iris metastasis from lung adenocarcinoma. This method was demonstrated in a case involving a 56-year-old male patient with EGFR-mutated lung adenocarcinoma.

Background

Iris metastasis is a rare but significant complication of systemic malignancies, particularly lung cancer. Accurate diagnosis is crucial for appropriate management and treatment of ocular symptoms. Traditional biopsy methods can be invasive, highlighting the need for less invasive diagnostic alternatives.

Data Highlights

Aqueous humor cytology revealed Class V findings consistent with metastatic adenocarcinoma in a patient with lung adenocarcinoma.

Key Findings

• Aqueous humor cytology diagnosed iris metastasis without biopsy in a patient with lung adenocarcinoma.
• The patient presented with elevated intraocular pressure and multiple elevated white iris nodules.
• Cytologic findings included atypical glandular epithelial cells with marked nuclear pleomorphism.
• Systemic restaging revealed multiple bone metastases despite the ocular disease appearing stable.
• Initial treatment for secondary glaucoma included topical medications and surgical interventions.
• Negative cytology results do not exclude metastatic disease; repeat sampling may be necessary.

Clinical Implications

Clinicians should remain vigilant for potential false-negative results and consider further diagnostic measures when clinical suspicion is high.

Conclusion

This case illustrates the use of aqueous humor cytology as a diagnostic alternative to biopsy for iris metastasis in selected patients.

Related Resources & Content

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