Detection of immunoglobulin heavy chain gene rearrangements by polymerase chain reaction analysis on lymph node imprints and fine-needle aspirate smears: a comparison of five different imprint preparations.
Five different preparations of lymph node imprints from 39 patients were studied to determine which preparations are suitable for obtaining interpretable results with polymerase chain reaction (PCR)-based detection of immunoglobulin heavy chain gene rearrangements and whether there are significant discrepancies in the patterns obtained. The sensitivity and specificity of this test for the diagnosis of B-cell lymphoma were assessed. The five imprints were stained with May-Grünwald-Giemsa (MGG) and coverslipped, stained with MGG but not coverslipped, fixed in acetone only, air-dried only, or immunostained, respectively. The efficiency of the PCR was 0% for immunocytochemically stained slides, 87% for air-dried only and air-dried/MGG-stained/coverslipped slides, 95% for air-dried/MGG-stained/not coverslipped slides, and 100% for imprints that were air-dried/acetone-fixed. There was total agreement in results in 87% cases studied. Discrepancies never resulted in false-positive test results. The overall sensitivity was 50%, and specificity was 100%. Based on these results, we have devised guidelines for tissue treatment when only stained slides are available. In a prospective study with 19 fine-needle aspirate specimens, the efficiency of the PCR increased to 100%, and sensitivity improved to 81%.
Torlakovic
E
E
Department of Pathology, Norwegian Radium Hospital, Oslo, Norway. emina-torlakovic@labmed.uio.no
Berner
A
A
Risberg
B
B
D001707:Biopsy, Needle; D015322:Gene Rearrangement, B-Lymphocyte; D005803:Genes, Immunoglobulin; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics*; D008198:Lymph Nodes; D016133:Polymerase Chain Reaction / Q000379:methods*; D011446:Prospective Studies; D012189:Retrospective Studies
D007143:Immunoglobulin Heavy Chains