The role of gene rearrangements for antigen receptors in the diagnosis of lymphoma obtained by fine-needle aspiration. A study of 63 cases with concomitant immunophenotyping.
To assess the efficacy of performing genotyping in addition to immunophenotyping as an adjunct to cytologic diagnosis, 63 consecutive patients with fine-needle aspirates of lymphoproliferative lesions who had concurrent immunophenotyping and genotyping performed on fine-needle aspirate cell suspensions were studied. Thirty-nine of 63 specimens (62%) that appeared to contain non-Hodgkin's lymphoma and that proved to be of B-cell lineage by genotyping were accurately phenotyped and shown to be monotypic for immunoglobulin light chains by cell suspension immunocytochemistry. Genotyping facilitated lineage assignment and/or confirmed clonality in 17 of 63 specimens (27%) that were difficult to determine based on morphologic data. These include cases of atypical lymphoid proliferations with polyclonal or inconclusive markers (n = 6), peripheral T-cell lymphoma (n = 3), extracutaneous mycosis fungoides (n = 1), lymphoblastic lymphoma (n = 4), null cell lymphoma (n = 1), and specimens with equivocal or technically unsatisfactory markers (n = 2). Based on these results, it is proposed that genotyping for lineage assignment and/or clonality be performed to include cases of atypical lymphoid proliferations, T-cell malignant neoplasms, lymphoid malignant neoplasms with equivocal markers, and differentiation of lymphoid from nonlymphoid neoplasms. Genotyping by antigen-receptor gene rearrangement appears to be redundant in cases with mature B-cell phenotypes that demonstrate monoclonality by immunophenotyping.
Katz
R L
RL
Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston 77030.
Hirsch-Ginsberg
C
C
Childs
C
C
Dekmezian
R
R
Fanning
T
T
Ordóñez
N
N
Cabanillis
F
F
Sneige
N
N
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D015139:Blotting, Southern; D015342:DNA Probes; D004273:DNA, Neoplasm / Q000032:analysis / Q000235:genetics*; D005260:Female; D015322:Gene Rearrangement, B-Lymphocyte; D015329:Gene Rearrangement, T-Lymphocyte; D006801:Humans; D016130:Immunophenotyping; D008223:Lymphoma / Q000175:diagnosis* / Q000235:genetics*; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000175:diagnosis / Q000235:genetics; D011946:Receptors, Antigen / Q000235:genetics; D011947:Receptors, Antigen, B-Cell / Q000235:genetics*; D011948:Receptors, Antigen, T-Cell / Q000235:genetics*
D015342:DNA Probes; D004273:DNA, Neoplasm; D011946:Receptors, Antigen; D011947:Receptors, Antigen, B-Cell; D011948:Receptors, Antigen, T-Cell