Sun T, Susin M, Desner M, Pergolizzi R, Cuomo J, Koduru P
Department of Laboratories, North Shore University Hospital, Manhasset, NY 11030.
Hum Pathol. 1990 Jul;21(7):722-8. doi: 10.1016/0046-8177(90)90032-z.
A case of Richter's syndrome was studied by morphology, immunohistochemistry, flow cytometry, and immunoglobulin gene rearrangement. Flow cytometric study clearly demonstrated two monoclonal populations. The use of double staining with CD 5/CD 19 antibodies accompanied by two-color flow cytometric analysis clearly defined the chronic lymphocytic leukemia population and separated it from the lymphoma population. Immunoglobulin heavy-chain gene analysis of blood and lymph node specimens revealed nonidentical as well as identical nongermline bands in these two populations. However, light-chain gene analysis demonstrated that both populations shared a common clonal origin. This result underscores the unreliability of using heavy chain genotype alone to identify clonal origin. Since post-rearrangement deletion, point mutation, and heavy chain switching occur in heavy chain genes, but are seldom seen in light chain genes, it is important to analyze both heavy and light chain genes to conclusively determine clonal origin.
通过形态学、免疫组织化学、流式细胞术和免疫球蛋白基因重排对1例里氏综合征病例进行了研究。流式细胞术研究清楚地显示了两个单克隆群体。使用CD 5/CD 19抗体双重染色并结合双色流式细胞术分析，明确界定了慢性淋巴细胞白血病群体，并将其与淋巴瘤群体区分开来。对血液和淋巴结标本进行的免疫球蛋白重链基因分析显示，这两个群体中存在不同以及相同的非种系条带。然而，轻链基因分析表明，两个群体具有共同的克隆起源。这一结果强调了仅使用重链基因型来确定克隆起源的不可靠性。由于重排后缺失、点突变和重链转换发生在重链基因中，但在轻链基因中很少见，因此分析重链和轻链基因对于最终确定克隆起源很重要。
