In Reply We thank Dr Margo for his comments concerning methods used to diagnose MALT lymphoma. The diagnosis of these lymphomas is usually made on the basis of morphology supported by immunohistochemical and flow cytometric studies. Polymerase chain reaction is rarely necessary. However, ophthalmic pathology biopsy specimens—particularly those of intraocular, optic nerve, or posterior orbital origin—may contain scant material, precluding flow cytometry. In such cases, the diagnosis is based on morphology and a limited number of immunohistochemical stains. The FNA biopsy performed in this case had the disadvantage of very limited available tissue, placing a premium on cytopathologic examination and a few immunohistochemical stains.
Demirci H, Elner VM. Contemplating the Diagnostic Certainty of Primary Iris Mucosa-Associated Lymphoid Tissue Lymphoma—Reply. JAMA Ophthalmol. 2015;133(8):970. doi:10.1001/jamaophthalmol.2015.1167