Division of Hematopathology, Rochester, MN, USA.
Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Am J Clin Pathol. 2022 Feb 3;157(2):286-292. doi: 10.1093/ajcp/aqab128.
Prognostically relevant chromosomal abnormalities in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) are routinely identified by fluorescence in situ hybridization (FISH) on peripheral blood or bone marrow specimens. We studied the prevalence of chromosomal abnormalities on extramedullary tissues involved by CLL/SLL and evaluated their association with prominent proliferation centers (PPCs).
FISH for recurrent abnormalities in CLL/SLL was performed on formalin-fixed, paraffin-embedded biopsy sections. PPCs were identified on H&E-stained sections. Available FISH results on peripheral blood or bone marrow specimens were also reviewed.
Recurrent FISH abnormalities were detected in 69% of 320 CLL/SLL biopsy specimens studied, including +12 (35%), 13q- (24%), 11q- (15%), 17p- (6%), 6q- (2%), and IGH/BCL2 (0.9%). Forty-three patients had abnormal blood or bone marrow FISH analyses, of whom 7 (16%) had discordant +12 and/or 13q-, and 3 (7%) had discordant 17p- or 11q-. Morphology was positive (17%), negative (78%), or equivocal (6%) for PPCs on 247 evaluable biopsy specimens, a finding not significantly associated with FISH results (P = .7).
Trisomy 12 is overrepresented in tumoral CLL/SLL involvement, compared with the known predominance of 13q- in blood. Discrepancies between leukemic and tissue FISH findings are occasionally encountered. FISH results do not correlate with the presence of PPCs.
在慢性淋巴细胞白血病/小淋巴细胞淋巴瘤(CLL/SLL)中,通过荧光原位杂交(FISH)在外周血或骨髓标本中常规识别预后相关的染色体异常。我们研究了累及 CLL/SLL 的骨髓外组织中的染色体异常的流行情况,并评估了它们与明显增殖中心(PPC)的关联。
对福尔马林固定、石蜡包埋的活检切片进行 CLL/SLL 中常见异常的 FISH 检测。在 H&E 染色切片上识别 PPC。还回顾了外周血或骨髓标本的可用 FISH 结果。
在 320 例研究的 CLL/SLL 活检标本中,检测到 69%的复发性 FISH 异常,包括+12(35%)、13q-(24%)、11q-(15%)、17p-(6%)、6q-(2%)和IGH/BCL2(0.9%)。43 例患者的血液或骨髓 FISH 分析异常,其中 7 例(16%)存在异常+12 和/或 13q-,3 例(7%)存在异常 17p-或 11q-。在 247 例可评估的活检标本中,形态学为 PPC 的阳性(17%)、阴性(78%)或不确定(6%),与 FISH 结果无显著相关性(P=0.7)。
与血液中已知的 13q-优势相比,在肿瘤性 CLL/SLL 中,三体 12 过度表达。偶尔会遇到白血病和组织 FISH 结果之间的差异。FISH 结果与 PPC 的存在无关。