Tiemann M, Menke M A, Asbeck R, Wacker H H, Parwaresch R
Department of Hematopathology, University of Kiel, Germany.
Electrophoresis. 1995 May;16(5):729-32. doi: 10.1002/elps.11501601118.
To analyze the transition of an autoimmune disease into a mucosa-associated lymphoid tissue-non-Hodgkin's lymphoma (MALT-NHL), we investigated a total of 27 cases of clinically diagnosed autoimmune thyroiditis with lymphoid hyperplasia. Three cases of thyroid hyperplasia served as controls. Monoclonal B cells were detected by studying rearrangement patterns of the hypervariable CDR III regions within the immunoglobulin heavy chain gene locus and the T-cell receptor gamma chain gene (TCRG). We used a seminested polymerase chain reaction (PCR) to demonstrate immunoglobulin rearrangements and a multiplex PCR for TCRG rearrangements. The PCR products were analyzed by temperature gradient gel electrophoresis to expand mixtures of homo- and hetero-duplices within heterogeneous populations of B cells. With this approach we found monoclonality in 14 of the 27 cases of Hashimoto's disease. In a reinvestigation we discovered additional histological and immunohistochemical features of MALT-NHL in 17 cases. The 14 cases of thyroiditis with clonally expanded B cells clearly demonstrate the transition from autoimmune disease to non-Hodgkin's lymphoma.
为分析自身免疫性疾病向黏膜相关淋巴组织非霍奇金淋巴瘤（MALT-NHL）的转变，我们共研究了27例临床诊断为伴有淋巴组织增生的自身免疫性甲状腺炎患者。3例甲状腺增生患者作为对照。通过研究免疫球蛋白重链基因座内高变互补决定区III（CDR III）区域和T细胞受体γ链基因（TCRG）的重排模式来检测单克隆B细胞。我们使用半巢式聚合酶链反应（PCR）来证明免疫球蛋白重排，使用多重PCR来检测TCRG重排。通过温度梯度凝胶电泳分析PCR产物，以扩增B细胞异质性群体中的同型和异型双链混合物。通过这种方法，我们在27例桥本氏病患者中的14例中发现了单克隆性。在再次研究中，我们在17例患者中发现了MALT-NHL的其他组织学和免疫组化特征。14例B细胞克隆性扩增的甲状腺炎病例清楚地证明了从自身免疫性疾病到非霍奇金淋巴瘤的转变。
