Takano T, Miyauchi A, Matsuzuka F, Yoshida H, Kuma K, Amino N
Department of Laboratory Medicine, Osaka University Medical School, Suita, Japan.
J Clin Endocrinol Metab. 2000 Feb;85(2):671-5. doi: 10.1210/jcem.85.2.6390.
Distinguishing between thyroid malignant lymphoma and lymphocytic thyroiditis (Hashimoto's thyroiditis) is quite difficult and problematic. Molecular techniques to detect clonal lymphoid proliferation based on Ig heavy chain (IgH) gene rearrangement may be used to facilitate more accurate diagnosis of malignant lymphoma. We recently established a method for diagnosing thyroid tumors by analyzing ribonucleic acids (RNAs) extracted from the needles used for fine needle aspiration biopsy (aspiration biopsy-RT-PCR). By applying the aspiration biopsy-RT-PCR method to detection of the monoclonality of IgH messenger RNA (mRNA), an accurate molecular-based diagnosis of malignant lymphoma can be established as an adjunct to cytological diagnosis. We first studied RNAs from fresh tissues samples of 8 cases of Hashimoto's thyroiditis and 18 malignant lymphomas to detect the monoclonality of IgH mRNA by seminested RT-PCR. Monoclonality was detected in 8 of 18 (44.4%) malignant lymphomas, but in none of the 8 cases of Hashimoto's thyroiditis. We then studied aspirates from 10 cases of thyroid malignant lymphoma, 4 cases of Hashimoto's thyroiditis, and 1 case each of adenomatous goiter and papillary carcinoma. Monoclonality was detected in the aspirates from 4 of 10 malignant lymphomas (40%), but not from other tissues. Thus, RT-PCR detection of monoclonality of IgH mRNA in addition to cytological examination may be useful in diagnosing thyroid malignant lymphoma.
区分甲状腺恶性淋巴瘤和淋巴细胞性甲状腺炎（桥本甲状腺炎）非常困难且存在问题。基于免疫球蛋白重链（IgH）基因重排检测克隆性淋巴样增殖的分子技术，可用于促进恶性淋巴瘤更准确的诊断。我们最近建立了一种通过分析细针穿刺活检所用针中提取的核糖核酸（RNA）来诊断甲状腺肿瘤的方法（穿刺活检逆转录聚合酶链反应）。通过将穿刺活检逆转录聚合酶链反应方法应用于检测IgH信使核糖核酸（mRNA）的单克隆性，作为细胞学诊断的辅助手段，可以建立基于分子的恶性淋巴瘤准确诊断。我们首先研究了8例桥本甲状腺炎新鲜组织样本和18例恶性淋巴瘤的RNA，通过半巢式逆转录聚合酶链反应检测IgH mRNA的单克隆性。在18例恶性淋巴瘤中的8例（44.4%）检测到单克隆性，但8例桥本甲状腺炎病例中均未检测到。然后我们研究了10例甲状腺恶性淋巴瘤、4例桥本甲状腺炎以及各1例腺瘤性甲状腺肿和乳头状癌的穿刺样本。在10例恶性淋巴瘤中的4例（40%）穿刺样本中检测到单克隆性，但其他组织样本中未检测到。因此，除细胞学检查外，通过逆转录聚合酶链反应检测IgH mRNA的单克隆性可能有助于诊断甲状腺恶性淋巴瘤。
