title: [Immunophenotyping and gene rearrangement analysis in lymphoid/lymphoproliferative disorders of the lungs].
abstract: OBJECTIVE
  To determine the usefulness, in routine practice, of using polymerase chain reaction to analyze B and T lymphocyte clonality in pulmonary tissue as a tool for the diagnosis of pulmonary lymphoproliferative disorders.
  
  
  METHODS
  Immunohistochemistry and molecular gene rearrangement analysis were performed in order to assess 8 cases of lymphoid interstitial pneumonia (LIP) and 7 cases of pulmonary lymphoproliferative disorders.
  
  
  RESULTS
  All 8 cases of LIP presented moderate to strong immunostaining for CD3, compared with only 2 cases of lymphoma and 1 case of pseudolymphoma (p = 0.02). Gene rearrangement was detected in 4 of the 8 cases, which changed the diagnosis from LIP to lymphoma, showing the importance of gene rearrangement detection in cases of LIP. In this situation, gene rearrangement using the VH/JH and Vgamma11/Jgamma12 primer pairs was detected in 3 cases and 1 case, respectively, and no gene abnormalities were found using the Dbeta1/Jbeta2 and Vgamma101/Jgamma12 primer pairs in any of the cases. A significant positive association was found between the intensity of CD20 and CD68 expression and gene rearrangement using the VH/JH primer pair. Prior to the gene rearrangement, 4 patients with LIP died quickly, whereas only one patient with LIP died after the gene rearrangement.
  
  
  CONCLUSIONS
  Detection of monoclonal B and T cells by immunophenotyping and polymerase chain reaction had an impact on the diagnosis of pulmonary lymphomas in patients previously diagnosed with LIP. Therefore, immunophenotyping and polymerase chain reaction should be used as 'gold standard' techniques in routine practice.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Camila Cristina
authors.initials: CC
authors.lastname: Ishikawa
authors.forename: Alexandre Muxfeldt
authors.initials: AM
authors.lastname: Ab'Saber
authors.forename: Edwin Roger
authors.initials: ER
authors.lastname: Parra
authors.forename: Chin Jia
authors.initials: CJ
authors.lastname: Lin
authors.forename: Carmen Silvia Valente
authors.initials: CS
authors.lastname: Barbas
authors.forename: Vera Luiza
authors.initials: VL
authors.lastname: Capelozzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000032:analysis; D016022:Case-Control Studies; D002675:Child, Preschool; D017931:DNA Primers; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D015321:Gene Rearrangement; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain / Q000235:genetics / Q000276:immunology; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor / Q000235:genetics / Q000276:immunology; D006801:Humans; D016130:Immunophenotyping; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000235:genetics / Q000276:immunology*; D008175:Lung Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000276:immunology*; D008221:Lymphoid Tissue / Q000473:pathology; D008223:Lymphoma / Q000175:diagnosis / Q000235:genetics / Q000276:immunology*; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D019310:Pseudolymphoma / Q000175:diagnosis / Q000235:genetics / Q000276:immunology; D012189:Retrospective Studies
chemical_list: D015703:Antigens, CD; D017931:DNA Primers