title: Utility of microdissection and polymerase chain reaction for the detection of immunoglobulin gene rearrangement and translocation in primary intraocular lymphoma.
abstract: OBJECTIVE
  Primary intraocular lymphoma, a non-Hodgkin's lymphoma, is a primary central nervous system lymphoma (PCNSL). Diagnosis is usually made by identifying malignant, large B lymphocytes in the vitreous, eye, brain, and cerebral spinal fluid; however, these cells are few, friable, and difficult to recognize. Recently, clonal heavy chain immunoglobulin (IgH) gene rearrangement and bcl-2 gene translocation have been reported in systemic B-cell lymphoma and are used for the detection of malignant cells and in making a diagnosis. The authors investigated the molecular changes in three eyes and a chorioretinal biopsy specimen of four patients with PCNSL.
  
  
  METHODS
  Human tissue study.
  
  
  METHODS
  Five ocular specimens of PCNSL were collected.
  
  
  METHODS
  The first patient had a diagnostic enucleation of the left eye. The second patient underwent diagnostic chorioretinal biopsy. In the third case, a pair of autopsied eyes with reactive lymphoplasmacytic infiltrates of a patient with acquired immune deficiency syndrome (AIDS) were studied. In the fourth case, an enucleated eye of a patient with AIDS-associated lymphoma was sampled.
  
  
  METHODS
  The bcl-2 and IgH genes of the lymphoma cells from routine, paraffin-embedded, formaldehyde-fixed, or frozen histologic tissue sections were analyzed using microdissection and polymerase chain reaction (PCR) technique.
  
  
  RESULTS
  Lymphoma cells obtained from the above four cases showed IgH rearrangement gene in the third framework of the VH region. Bcl-2-associated translocation also was detected in three cases (cases 1, 2, and 4).
  
  
  CONCLUSIONS
  Rearrangement of the IgH gene can serve as a molecular marker for PCNSL. Microdissection allows for procurement and analysis of specific, selected, minute cell populations that are obtained from histologic sections of the complex, heterogeneous tissue. Translocation of IgH and bcl-2, the apoptotic "survival" signal and proto-oncogene, could contribute to the pathogenesis of PCNSL. The combination of microdissection and PCR is a powerful tool for studies of small lesions and cell populations and for understanding disease mechanisms.
authors.affiliation: Laboratory of Immunology, National Eye Institute, Bethesda, Maryland, USA.
authors.forename: D F
authors.initials: DF
authors.lastname: Shen
authors.forename: Z
authors.initials: Z
authors.lastname: Zhuang
authors.forename: P
authors.initials: P
authors.lastname: LeHoang
authors.forename: R
authors.initials: R
authors.lastname: Böni
authors.forename: S
authors.initials: S
authors.lastname: Zheng
authors.forename: R B
authors.initials: RB
authors.lastname: Nussenblatt
authors.forename: C C
authors.initials: CC
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D017931:DNA Primers / Q000737:chemistry; D004273:DNA, Neoplasm / Q000032:analysis; D004210:Dissection; D005260:Female; D015321:Gene Rearrangement; D005803:Genes, Immunoglobulin / Q000235:genetics*; D019254:Genes, bcl-2 / Q000235:genetics; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D016393:Lymphoma, B-Cell / Q000235:genetics* / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019574:Optic Nerve Neoplasms / Q000235:genetics* / Q000473:pathology; D016133:Polymerase Chain Reaction; D000090063:Proto-Oncogene Mas; D014178:Translocation, Genetic
chemical_list: D015415:Biomarkers; D017931:DNA Primers; D004273:DNA, Neoplasm; D007143:Immunoglobulin Heavy Chains; C000715470:MAS1 protein, human; D000090063:Proto-Oncogene Mas