[Immunoglobulin rearrangement in the differential diagnosis of primary gastric lymphoma].
BACKGROUND
The traditional methods to distinguish Chronic Follicular Gastritis and Primary Gastric Lymphoma do not allow an adequate definitive diagnosis in a significant number of cases. The molecular Biology diagnostic methods are based on the rearrangement of immunoglobulin genes. The polymerase chain reaction (PCR) specifically amplifies this rearrangement and allows molecular analysis of minimal tissue samples obtained with endoscopical biopsies.


OBJECTIVE
To test the usefulness of this PCR method in the differential diagnosis between Chronic Follicular Gastritis and Primary Gastric Lymphoma.


METHODS
We analyzed the endoscopical biopsies of six Chronic Follicular Gastritis cases and eight surgically treated Primary Gastric Lymphoma cases, six with the correct diagnosis in the endoscopical biopsies and two with a diagnosis of Chronic Follicular Gastritis.


RESULTS
A policlonal immunoglobulin rearrangement was found in the six cases with Chronic Follicular Gastritis. A monoclonal arrangement was found in 5 of 6 biopsies with the diagnosis of Primary Gastric Lymphoma. The same monoclonal rearrangement was observed in the two biopsies incorrectly diagnosed as Chronic Follicular Gastritis.


CONCLUSIONS
PCR analysis of immunoglobulin rearrangement is a useful method in the differential diagnosis between Chronic Follicular Gastritis and Primary Gastric Lymphoma.
Corvalán
A
A
Laboratorio de Patología, Instituto Chileno Japonés de Enfermedades Digestivas, Hospital, Clínico San Borja Arriarán.
Aguayo
F
F
Pisano
R
R
Palma
M
M
Backhouse
C
C
Vargas
A
A
Martínez
C
C
Rubio
M
M
D002908:Chronic Disease; D003937:Diagnosis, Differential; D004587:Electrophoresis, Agar Gel; D005758:Gastritis, Hypertrophic / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000235:genetics*; D008223:Lymphoma / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D016133:Polymerase Chain Reaction; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology
D007136:Immunoglobulins