Primary central nervous system lymphoma: tumor-related clones exist in the blood and bone marrow with evidence for separate development.
Primary central nervous system (CNS) lymphoma is an aggressive B-cell tumor that is defined clinically by the absence of systemic disease. We have used immunoglobulin variable (V)-gene analysis to identify tumor cells at the CNS site in 12 cases and to probe the involvement of peripheral tissues in 3 patients. Clonal tracking revealed tumor cells in the bone marrow and/or blood for 3 of 3 cases, with evidence for increased V-gene mutational activity at peripheral sites. In 2 of 3 cases, intraclonal variant analysis revealed identity with the brain biopsy but detected additional variants unique to extracerebral sites. These findings suggest that peripheral tumor cells can undergo separate development locally with no reentry into the brain. Primary CNS lymphoma appears to have both CNS-specific and systemic components with limited interchange. The more malignant behavior of tumor cells in the CNS suggests either a local environmental influence or a less malignant phenotype of the peripheral clone.
McCann
Katy J
KJ
Translational Immunotherapy Group, Cancer Sciences Division, University of Southampton School of Medicine, Southampton, United Kingdom.
Ashton-Key
Margaret
M
Smith
Kellyann
K
Stevenson
Freda K
FK
Ottensmeier
Christian H
CH
D001483:Base Sequence; D001853:Bone Marrow / Q000473:pathology*; D001932:Brain Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000235:genetics; D016543:Central Nervous System Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000235:genetics; D002999:Clone Cells / Q000276:immunology / Q000473:pathology*; D003564:Cytidine Deaminase / Q000235:genetics / Q000378:metabolism; D015321:Gene Rearrangement; D006801:Humans; D007124:Immunoenzyme Techniques; D007135:Immunoglobulin Variable Region / Q000235:genetics*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000097:blood / Q000175:diagnosis* / Q000235:genetics; D008969:Molecular Sequence Data; D009154:Mutation; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D012689:Sequence Homology, Nucleic Acid; D000098830:AICDA (Activation-Induced Cytidine Deaminase)
D007135:Immunoglobulin Variable Region; D012333:RNA, Messenger; D000098830:AICDA (Activation-Induced Cytidine Deaminase); D003564:Cytidine Deaminase