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Aqueous cytology may diagnose iris metastasis without biopsy
Aqueous humor sampling confirmed iris metastasis in a patient with refractory secondary glaucoma and lung adenocarcinoma, avoiding iris tissue sampling.
To evaluate the effectiveness of aqueous humor cytology in diagnosing iris metastasis from lung adenocarcinoma based on a single patient case without the need for a tissue biopsy.
Approach:
Patient Case: A 56-year-old male with EGFR-mutated lung adenocarcinoma presented with decreased vision and elevated intraocular pressure in the right eye.
Diagnostic Method: Aqueous humor was obtained through anterior chamber paracentesis, revealing atypical glandular epithelial cells consistent with metastatic adenocarcinoma.
Key Findings:
Aqueous humor cytology diagnosed iris metastasis without biopsy.
The cytologic findings were classified as Class V, indicating metastatic adenocarcinoma.
The patient had systemic disease that appeared clinically stable at the time of ocular presentation.
Interpretation:
Aqueous humor cytology can be a less invasive diagnostic tool for iris metastasis, but false negatives are possible.
Limitations:
False-negative results may occur depending on tumor burden and sampling volume.
The study is based on a single patient case, necessitating larger studies for validation.
Conclusion:
Cytologic analysis of aqueous humor can be a valuable diagnostic alternative to biopsy in selected patients with high clinical suspicion of iris metastasis, but further studies are needed for validation.
