Abstract

SO.19.04

Histopathological artefacts in enucleated eyes with retinoblastoma

Richter M. N.¹, Braun-Elwert S.¹, Willerding G.¹, Coupland S. E.², Heimann H.², Foerster M. H.¹, Bechrakis N. E.^1
1Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; ²St Paul`s Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom

Objective: Microscopic uveal and optic nerve invasion in retinoblastoma can have therapeutic consequences. For genetic testing, it may be necessary to assess fresh tumour tissue before formalin fixation. Due to the soft and friable texture of the tumour, retinoblastoma cells can easily be scattered on opening the globe and simulate tumour cell invasion of adjacent tissues (artefacts).
Methods: Fifty eyes of 49 patients with retinoblastoma (enucleation between 1993 and 2005) were examined in a retrospective study. In 24 eyes, tumour material was taken before fixation (group 2), the others were directly fixed in formalin (group 1). Incidence, localisation and character of the artefacts were evaluated. Two kinds of artefacts were specified: Preparation artefacts (found in a different plane than the tumour section) and plane artefacts (found in the same level as the rest of the section).
Results: Plane artefacts were found in both groups in 23 eyes. The number of artefacts was higher in eyes cut open before fixation (97 level artefacts) compared to eyes fixed directly (53 artefacts). Preparation artefacts were more frequent and found in all eyes: 162 in group 2 and 173 in group 1. Most of the artefacts appeared as tumour cell groups.
Conclusions: Overall, artefacts were found in 96% of all eyes opened before fixation and in 88% of directly fixed eyes. Preparation artefacts were more often than plane artefacts. Examination of several levels and information about fixation is important for the evaluation of the tumour.

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