Rearrangement of immunoglobulin gene in metastatic Waldenström macroglobulinemia to the vitreous.
OBJECTIVE
To report metastatic Waldenström macroglobulinemia cells with immunoglobulin heavy chain gene rearrangement in the vitreous and the blood.


METHODS
A 58-year-old man with Waldenström macroglobulinemia developed bilateral vitreitis. Diagnostic vitrectomy was performed on the left eye. The vitreous cells and the peripheral blood lymphocytes were analyzed using microdissection and polymerase chain reaction amplification.


RESULTS
Vitrectomy specimen of the left eye contained a few degenerated cells. Molecular analysis showed immunoglobulin heavy chain gene rearrangement at the third complementary determining region of the vitreal infiltrating cells and peripheral blood lymphocytes.


CONCLUSIONS
Waldenström macroglobulinemia rarely metastasizes to the vitreous. Molecular detection of the immunoglobulin heavy chain gene third complementary determining region rearrangement is helpful in the diagnosis of the malignancy. Microdissection combined with polymerase chain reaction is a useful and innovative tool for molecular pathological investigation.
Shen
D F
DF
Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Md 20892-1857, USA.
Fardeau
C
C
Roberge
F G
FG
LeHoang
P
P
Chan
C C
CC
D001402:B-Lymphocytes / Q000473:pathology; D004247:DNA / Q000032:analysis; D005128:Eye Diseases / Q000175:diagnosis / Q000235:genetics*; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain; D005803:Genes, Immunoglobulin / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology*; D008258:Waldenstrom Macroglobulinemia / Q000175:diagnosis / Q000235:genetics*
D004247:DNA