title: Clonality testing of malignant lymphomas with the BIOMED-2 primers in a large cohort of 1969 primary and consultant biopsies.
abstract: The introduction of the BIOMED-2 primers allowed for reliable comparisons of clonality testing data of malignant lymphomas from different laboratories. This study undertook a retrospective analysis of a large cohort of cases; 1862 cases involved the immunoglobulin heavy chain locus (IGH VH-JH), and 1527 cases involved the T cell receptor gamma locus (TCRG). We confirmed previously published clonality rates in various B cell, T cell, and Hodgkin lymphoma cases. In reactive lesions, clonality for the IGH locus was frequently accompanied by additional polyclonal background. Clonality for TCRG was found in a subgroup of diffuse large B cell lymphomas. On closer morphologic inspection, seven cases appeared to have arisen from an underlying peripheral T-cell lymphoma. Five cases with monoclonal TCRG rearrangements, originally diagnosed as Hodgkin lymphomas, were reclassified as T-cell lymphomas. TCRG clonality was very rarely only observed in Hodgkin lymphoma. In case of clear TCRG clonality a T-cell neoplasia must be ruled out on morphological grounds. By careful examination of the rearrangement patterns, including an assessment of a co-amplified polyclonal background, clonality testing provides a powerful tool which in concert with morphologic and immunohistochemical parameters can lead to a firm diagnosis.
authors.affiliation: Senckenberg Institute of Pathology, Goethe University, 60590 Frankfurt am Main, Germany. s.hartmann@em.uni-frankfurt.de
authors.forename: Sylvia
authors.initials: S
authors.lastname: Hartmann
authors.forename: Alexandra
authors.initials: A
authors.lastname: Helling
authors.forename: Claudia
authors.initials: C
authors.lastname: Döring
authors.forename: Christoph
authors.initials: C
authors.lastname: Renné
authors.forename: Martin-Leo
authors.initials: ML
authors.lastname: Hansmann
mesh_terms: D001706:Biopsy; D002999:Clone Cells; D017931:DNA Primers; D003937:Diagnosis, Differential; D015321:Gene Rearrangement; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor; D050438:Genes, Immunoglobulin Heavy Chain; D019675:Genes, T-Cell Receptor gamma; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods*; D006689:Hodgkin Disease / Q000235:genetics / Q000276:immunology; D006801:Humans; D008223:Lymphoma / Q000145:classification / Q000235:genetics* / Q000276:immunology / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000235:genetics / Q000276:immunology; D016399:Lymphoma, T-Cell / Q000235:genetics / Q000276:immunology; D010641:Phenotype; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012017:Referral and Consultation; D012189:Retrospective Studies
chemical_list: D017931:DNA Primers
keywords: Clonality; Hodgkin lymphoma; Non-Hodgkin lymphoma; Reactive lesions