title: Oligoclonality of a "composite" gastric diffuse large B-cell lymphoma with areas of marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue type.
abstract: We analyzed a case of oligoclonal Helicobacter pylori-associated, primary gastric diffuse large B-cell lymphoma (DLBCL) with areas of extranodal marginal zone B-cell lymphoma (MZBL) of mucosa-associated lymphoid tissue (MALT) type in a 61-year-old male patient. The patient had two separate tumors, in the corpus and in the antrum, each showing two morphologically distinct components (DLBCL and MZBL of MALT type). To determine the clonal relationship between the large- and small-cell components, we microdissected four samples from morphologically distinct tumor components at both tumor sites. PCR analysis revealed rearranged immunoglobulin heavy chain (IgH) genes of different sizes in three of the four microdissected samples. Cloning and sequencing of the PCR products displayed different IgH gene rearrangements in the two small cell components of the antrum and the corpus. A third genuinely differently rearranged IgH gene was found in the large-cell components of both antrum and corpus. Our results suggest that in primary gastric DLBCL with areas of MZBL of MALT type, the small-cell component may comprise more than one tumor clone. Furthermore, the large-cell component may evolve independently from coexisting MZBL.
authors.affiliation: Department of Pathology, GSF-National Research Center for Environment and Health, Neuherberg, Germany. ad.cabras@lrz.tum.de
authors.forename: Antonello Domenico
authors.initials: AD
authors.lastname: Cabras
authors.forename: Gregor
authors.initials: G
authors.lastname: Weirich
authors.forename: Falko
authors.initials: F
authors.lastname: Fend
authors.forename: Jörg
authors.initials: J
authors.lastname: Nährig
authors.forename: Cesare
authors.initials: C
authors.lastname: Bordi
authors.forename: Heinz
authors.initials: H
authors.lastname: Höfler
authors.forename: Martin
authors.initials: M
authors.lastname: Werner
mesh_terms: D000595:Amino Acid Sequence; D001483:Base Sequence; D002999:Clone Cells; D004273:DNA, Neoplasm / Q000032:analysis; D004210:Dissection; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain; D006801:Humans; D016130:Immunophenotyping; D018442:Lymphoma, B-Cell, Marginal Zone / Q000235:genetics* / Q000276:immunology / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000235:genetics* / Q000276:immunology / Q000473:pathology; D008297:Male; D008846:Micromanipulation; D008875:Middle Aged; D008969:Molecular Sequence Data; D016609:Neoplasms, Second Primary / Q000235:genetics* / Q000276:immunology / Q000473:pathology; D016133:Polymerase Chain Reaction; D013274:Stomach Neoplasms / Q000235:genetics* / Q000276:immunology / Q000473:pathology
chemical_list: D004273:DNA, Neoplasm