title: Diagnosis of B-cell lymphoma. Utility of the polymerase chain reaction for detecting clonality from archival cytologic smears.
abstract: 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.
authors.affiliation: 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
authors.forename: Miho
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Kitamura
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nishio
authors.forename: Midori
authors.initials: M
authors.lastname: Ishii
authors.forename: Naomi
authors.initials: N
authors.lastname: Kawano
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Inayama
authors.forename: Yohei
authors.initials: Y
authors.lastname: Miyagi
authors.forename: Akinori
authors.initials: A
authors.lastname: Nozawa
authors.forename: Yukio
authors.initials: Y
authors.lastname: Nakatani
mesh_terms: 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
chemical_list: D004273:DNA, Neoplasm