Detection of concurrent/recurrent non-Hodgkin's lymphoma in effusions by PCR.
A subset of patients with non-Hodgkin's lymphoma (NHL), present with or subsequently develop lymphocytic effusions. Differential diagnosis between reactive lymphocytosis and recurrent low-grade NHL is difficult by cytology alone. We studied the use of polymerase chain reaction (PCR)-based techniques to detect concurrent/recurrent NHL. Both primary tumors and atypical lymphocytic effusions of 12 low-grade B-NHL patients and 4 T-NHL patients were studied. Six pleural effusions (reactive/carcinomatous), in patients with no history of NHL, were included. Samples were amplified by PCR, using Fr3, Fr2, LJH, and VLJH primers specific for the immunoglobulin heavy chain (IgH) gene and Vgamma-8, Vgamma9, Vgamma10, Vgamma11 and Jgamma1/Jgamma2 consensus primers specific for the T-cell receptor gamma (TCR-gamma) gene. IgH gene PCR products were analyzed by polyacrylamide gel electrophoresis (PAGE). TCR-gamma gene PCR products were analyzed using a novel nonradioactive single-strand conformational polymorphism (SSCP) procedure. IgH gene rearrangement analysis demonstrated monoclonality in 11/12 primary low-grade B-NHLs. Identical monoclonal bands were found in both primary tumor and effusion in 9 patients. TCR-gamma gene rearrangement analysis demonstrated monoclonality in 4 of 4 primary T-NHLs. Identical monoclonal banded patterns were found in both primary tumor and effusion in 3 patients. Our results strongly support the diagnosis of concurrent/recurrent NHL in 13 of 16 (81%) cases of atypical lymphocytic effusions. IgH/PAGE and TCR-gamma/SSCP analyses are useful tools in the diagnoses of lymphocytic effusions in patients with NHL.
Murphy
M
M
Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Signoretti
S
S
Nasser
I
I
Sherburne
B
B
Loda
M
M
D003937:Diagnosis, Differential; D005122:Exudates and Transudates / Q000166:cytology; D015321:Gene Rearrangement; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor / Q000235:genetics; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D008218:Lymphocytosis / Q000235:genetics* / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000235:genetics* / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000235:genetics* / Q000473:pathology*; D016133:Polymerase Chain Reaction; D018807:Polymorphism, Single-Stranded Conformational
D007143:Immunoglobulin Heavy Chains