Miettinen M, Lasota J
Armed Forces Institute of Pathology, Department of Soft Tissue Pathology, Washington, DC, USA.
Pathol Res Pract. 1997;193(1):9-19. doi: 10.1016/S0344-0338(97)80089-1.
The diagnostic potential of PCR-based studies on the immunoglobulin heavy chain (IgH) gene rearrangements and the t(14;18) translocation was evaluated in a series of 30 benign and 46 malignant follicular lymphoid lesions including difficult problem cases using formaldehyde-fixed and paraffin-embedded (FFPE) tissue. Clonal IgH gene rearrangement was documented by PCR in 38/46 follicular lymphomas using two alternative (FR3A and FR2A-based) primer systems: all benign hyperplasias showed a polyclonal pattern. The t(14;18) translocation was documented in 20/46 cases, including cases that did not show a clonal IgH gene amplification; a weak signal was seen in 6 benign hyperplasias probably related to the recently described rare non-neoplastic cells carrying the t(14;18) translocation. Of the translocations in follicular lymphomas, 18 involved the major breakpoint region (MBR) and two the minor cluster region (MCR). The diagnosis of follicular lymphoma could be reached with at least one marker in over 90% of the cases. With these tests we diagnosed an incidental follicular lymphoma in the axillary dissection for breast carcinoma, and confirmed benign nature of an extreme follicular hyperplasia with a 2200 g spleen. One diffuse large cleaved cell lymphoma with subsequent follicular small cleaved cell lymphoma was diagnosed to have a similar t(14;18) translocation showing a link between the two seemingly different lymphomas.
在一系列30例良性和46例恶性滤泡性淋巴样病变（包括疑难病例）中，利用甲醛固定石蜡包埋（FFPE）组织，评估了基于聚合酶链反应（PCR）研究免疫球蛋白重链（IgH）基因重排和t(14;18)易位的诊断潜力。采用两种替代引物系统（基于FR3A和FR2A），通过PCR在38/46例滤泡性淋巴瘤中记录到克隆性IgH基因重排：所有良性增生均显示多克隆模式。在20/46例病例中记录到t(14;18)易位，包括未显示克隆性IgH基因扩增的病例；在6例良性增生中可见微弱信号，可能与最近描述的携带t(14;18)易位的罕见非肿瘤细胞有关。在滤泡性淋巴瘤的易位中，18例涉及主要断裂点区域（MBR），2例涉及次要簇区域（MCR）。超过90%的病例通过至少一种标志物可确诊滤泡性淋巴瘤。通过这些检测，我们在乳腺癌腋窝淋巴结清扫术中诊断出1例偶然发现的滤泡性淋巴瘤，并证实了1例脾脏重达2200 g的极度滤泡增生的良性性质。1例弥漫性大裂细胞淋巴瘤继发滤泡性小裂细胞淋巴瘤被诊断为具有相似的t(14;18)易位，显示出这两种看似不同的淋巴瘤之间存在联系。
