Diagnosis of B-cell lymphoma. Utility of the polymerase chain reaction for detecting clonality from archival cytologic smears.
OBJECTIVE
To apply the polymerase chain reaction (PCR) to detect clonality for potentially helping to establish a definitive diagnosis of lymphoma in cytologic material.


METHODS
In this retrospective study, Papanicolaou-stained cytologic smears and formalin-fixed, paraffin-embedded tissues from 17 cases of B-cell lymphoma were examined to investigate their clonality by a PCR technique using three different approaches (FR3, FR3A and FR2) for amplification of immunoglobulin heavy chain genes. Cytologic smears from 10 cases of nonneoplastic lymphoid tissues and T-cell lymphomas served as negative controls.


RESULTS
Monoclonality was detected in 9 of 17 cases (53%) of B-cell lymphoma in cytologic smears as compared with 8 of 16 cases (50%) in tissue sections. Semi-nested PCRs (FR3A/FR2) were superior to the single PCR (FR3) in the detection rate (41% vs. 18%). Five of seven cases (71%) of marginal zone B-cell lymphomas showed monoclonality, whereas only 4 of 10 cases (40%) of diffuse large B-cell lymphomas did so. Monoclonality was demonstrated in none of the negative controls.


CONCLUSIONS
Clonality detection in B-cell lymphomas by PCR using cytologic smears is specific and equal in sensitivity to that using formalin-fixed, paraffin-embedded tissues. The detection rate is especially excellent in marginal zone B-cell lymphoma, in which the cytologic diagnosis is particularly challenging. Combined seminested PCRs for FR3A and FR2 are advocated for a reliable assessment of clonality.
Kikuchi
Miho
M
Division of Anatomic and Surgical Pathology, Department of Pathology, Hospital of Yokohama City University, Yokohama City University School of Medicine, Kanagawa Cancer Center Research Institute, Yokohama, Japan. patho@urahp.yokohama-cu.ac.jp
Kitamura
Kazuhisa
K
Nishio
Yukiko
Y
Ishii
Midori
M
Kawano
Naomi
N
Inayama
Yoshiaki
Y
Miyagi
Yohei
Y
Nozawa
Akinori
A
Nakatani
Yukio
Y
D001706:Biopsy; D002454:Cell Differentiation; D004273:DNA, Neoplasm / Q000032:analysis / Q000235:genetics; D006801:Humans; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D016133:Polymerase Chain Reaction / Q000379:methods; D012189:Retrospective Studies
D004273:DNA, Neoplasm