Multiparameter analysis for discreet differential diagnosis of mucosa-associated lymphoid tissue lymphoma in the intestine.
BACKGROUND
The diagnosis of mucosa-associated lymphoid tissue (MALT) lymphoma in the intestine is occasionally difficult from histological examination on small biopsy specimens obtained by endoscopy. This study focused on unusual cases of reactive lymphoproliferative disorders in the intestine in order to make a differential diagnosis of MALT lymphoma.


METHODS
Five patients were examined with regards to clinical symptoms, endoscopic findings and multiparameter analysis (the morphological examination using routine hematoxylin and eosin staining by light microscopy, immunophenotyping by flow cytometry (FCM), immunohistochemistry and genotyping of extracted DNA).


RESULTS
All cases showed an aggregation of lymphocytes and one case showed similar features to lymphoepithelial lesions. Analyses of FCM and genetic rearrangements denied the monoclonality in all cases. Consequently, we considered that all cases should be diagnosed as reactive lymphoid hyperplasia and inflammatory change.


CONCLUSIONS
Multiparameter analysis is useful in making an exact diagnosis of MALT lymphoma and therefore contributes to prevent unnecessary overtreatment.
Nomura
Eiki
E
Tohoku University, Graduate School of Medicine, Sendai, Japan. enomura@int3.med.tohoku.ac.jp
Takagi
Sho
S
Ichinohasama
Ryo
R
Kikuchi
Tatsuya
T
Shiraki
Manabu
M
Oomori
Shinya
S
Yokoyama
Hiroshi
H
Utsunomiya
Kyoko
K
Negoro
Kenichi
K
Aihara
Hiroyuki
H
Takahashi
Seiichi
S
Kinouchi
Yoshitaka
Y
Shimosegawa
Tooru
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D004273:DNA, Neoplasm / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D005434:Flow Cytometry; D005838:Genotype; D006801:Humans; D007124:Immunoenzyme Techniques; D016130:Immunophenotyping; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis
D004273:DNA, Neoplasm