Cabras Antonello Domenico, Weirich Gregor, Fend Falko, Nährig Jörg, Bordi Cesare, Höfler Heinz, Werner Martin
Department of Pathology, GSF-National Research Center for Environment and Health, Neuherberg, Germany.
Virchows Arch. 2002 Feb;440(2):209-14. doi: 10.1007/s004280100504.
We analyzed a case of oligoclonal Helicobacter pylori-associated, primary gastric diffuse large B-cell lymphoma (DLBCL) with areas of extranodal marginal zone B-cell lymphoma (MZBL) of mucosa-associated lymphoid tissue (MALT) type in a 61-year-old male patient. The patient had two separate tumors, in the corpus and in the antrum, each showing two morphologically distinct components (DLBCL and MZBL of MALT type). To determine the clonal relationship between the large- and small-cell components, we microdissected four samples from morphologically distinct tumor components at both tumor sites. PCR analysis revealed rearranged immunoglobulin heavy chain (IgH) genes of different sizes in three of the four microdissected samples. Cloning and sequencing of the PCR products displayed different IgH gene rearrangements in the two small cell components of the antrum and the corpus. A third genuinely differently rearranged IgH gene was found in the large-cell components of both antrum and corpus. Our results suggest that in primary gastric DLBCL with areas of MZBL of MALT type, the small-cell component may comprise more than one tumor clone. Furthermore, the large-cell component may evolve independently from coexisting MZBL.
我们分析了一例61岁男性患者的寡克隆性幽门螺杆菌相关的原发性胃弥漫性大B细胞淋巴瘤（DLBCL），其具有黏膜相关淋巴组织（MALT）型结外边缘区B细胞淋巴瘤（MZBL）区域。该患者在胃体和胃窦有两个独立的肿瘤，每个肿瘤均显示出两种形态学上不同的成分（DLBCL和MALT型MZBL）。为了确定大细胞和小细胞成分之间的克隆关系，我们从两个肿瘤部位形态学不同的肿瘤成分中显微切割了四个样本。PCR分析显示，在四个显微切割样本中的三个样本中存在大小不同的重排免疫球蛋白重链（IgH）基因。PCR产物的克隆和测序显示，胃窦和胃体的两个小细胞成分中存在不同的IgH基因重排。在胃窦和胃体两者的大细胞成分中发现了第三个真正不同重排的IgH基因。我们的结果表明，在具有MALT型MZBL区域的原发性胃DLBCL中，小细胞成分可能包含不止一个肿瘤克隆。此外，大细胞成分可能独立于共存的MZBL而演变。
