Abstract
The specificity of polymerase chain reactionmonoclonality in the diagnosis of gastric lymphoma wasprospectively evaluated. Gastric mucosal tissue fromnormal gastric mucosa (N = 13), benign gastric ulcers (N = 3), chronic Helicobacter pylori gastritis(N = 3), gastric mucosa-associated lymphoid tissue (N =16), and gastric lymphoma (N = 15) was obtained.Polymerase chain reaction amplification of theheavy-chain framework 2A gene was performed. Thesensitivity and specificity of heavy-chain clonality, inthe detection of gastric lymphoma, were 73.3% and 45.7%,respectively. Determination of monoclonality bypolymerase chain reaction methodology is not an acceptabletechnique for confirming the diagnosis of gastriclymphoma as it is too sensitive, detecting minutepopulations of clonal lymphocytes that occur in benign diseases as well as larger populations ofclonal lymphocytes associated with malignant gastriclymphoproliferative diseases. Southern blot generearrangement testing should be utilized to determineclonality in the evaluation of gastric lymphocyticinfiltrates.
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REFERENCES
Isaacson PG, Spencer J: Malignant lymphoma of mucosa-associated lymphoid tissue. Histopathology 11:445–462, 1987
Wotherspoon AC, Doglioni C, Diss TC, Pan L, Moschini A, de Boni M, Isaacson PG: Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori. Lancet 342:575–577, 1993
Bayerdorfer E, Neubauer A, Rudolph B, Theide C, Lehn N, Eidt S, Stolte M, for Malt Lymphoma Study Group. Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pyloriinfection. Lancet 345:1591–1594, 1995
Roggero E, Zucca E, Pinotti G, Pascarella A, Capella C, Savio A, Pedrinis E, Paterlini A, Venco A, Cavalli F: Eradication of Helicobacter pyloriinfection in primary low-grade gastric lymphoma of mucosa-associated lymphoid tissue. Ann Intern Med 122:767–769, 1995
Yardley JH, Hendrix TR: Gastritis, duodenitis, and associated ulcerative lesions. InTextbook of Gastroenterology. T Yamada, DH Alpers, C Owyang, DW Powell, FE Silverstein (eds). Philadelphia, JB Lippincott, 1995, pp 1456–1493
Isaacson PG, Norton AJ: Extranodal Lymphomas. New York, Churchill Livingstone, 1994
Zukerberg LR, Ferry JA, Southern JF, Harns NL: Lymphoid infiltrates of the stomach. Evaluation of histologic criteria for the diagnosis of low-grade gastric lymphoma on endoscopic biopsy specimens. Am J Surg Pathol 14:1087–1099, 1990
Isaacson PG: Gastrointestinal lymphomas and lymphoid hyperplasia. InNeoplastic Hematopathology. DM Knowles (ed). Baltimore, Williams and Wilkins, 1992, pp 953–978
Isaacson PG: Gastrointestinal lymphoma. Hum Pathol 25:1020–1029, 1994
Cleary ML, Chao J, Warnke R, Sklar J: Immunoglobulin gene rearrangement as a diagnostic criterion of B-cell lymphoma. Proc Natl Acad Sci USA 81:593–597, 1984
Cossman J, Zehnbauer B, Garrett CT, Smith LJ, Williams M, Jaffe ES, Hanson LO, Love J: Gene rearrangements in the diagnosis of lymphoma/leukemia. Guidelines for the use based on a multiinstitutional study. Am J Clin Pathol 95:347–354, 1991
Cossman J, Uppenkamp M, Sundeen J, Coupland R, Raffeld M: Molecular genetics and the diagnosis of lymphoma. Arch Pathol Lab Med 112:117–127, 1988
Pittaluga S, Uppenkamp M, Cossman J: Development of T3/T cell receptor gene expression in human pre-T neoplasms. Blood 69:1062–1067, 1987
Petterson V, Sambrook J: Amount of viral DNA in the genome of cells transformed by adenovirus type 2. J Mol Biol 73:125–130, 1973
Sambrook J, Fritsch EF, Maniatis T: Molecular Cloning. Cold Spring Harbor, New York, Cold Spring Harbor Laboratory Press, 1989
Banerjee SK, Makdisi WF, Weston AP, Campbell DR: Microwave-based DNA extraction from paraffin-embedded tissue for PCR amplification. Bio Techniques 18:768–770, 772–773, 1995
Davis LG, Dibner MD. Battey JF: Basic Methods in Molecular Biology. New York, Elsevier Science Publishing, 1986
Banerjee SK, Makdisi WF, Weston AP, Campbell DR: A two-step PCR technique enhances sensitivity for detecting K-rasmutations in pancreatic adenocarcinoma. Pancreas 15:16–24, 1997
Miller CW, Simon K, Aslo A, Kok K, Yokota J, Buys CH, Terada M, Koeffler HP: p53mutations in human ling tumors. Cancer Res 52:1695–1698, 1992
Kwok S, Higuchi R: Avoiding false positives with PCR. Nature 339:237–238, 1989
Ramasamy I, Brisco M, Morley A: Improved PCR method for detecting monoclonal immunoglobulin heavy chain re arrange-ment in B cell neoplasms. J Clin Pathol 45:770775, 1992
Diss TC, Peng H, Wotherspoon AC, Isaacson PG, Pan L: Detection of monoclonality in low-grade B-cell lymphomas using the polymerase chain reaction is dependent upon primer selection and lymphoma type. J Pathol 169:291–295, 1993
Achille A, Scarpa A, Montresor M, Scardoni M, Zamboni G, Chilosi M, Capelli P, Franzin G, Menestrina F: Routine application of polymerase chain reaction in the diagnosis of monoclonality of B-cell lymphoid proliferations. Diagn Mol Pathol 4:1424, 1995
Kabat EA: Sequence s of Proteins of Immunological Interest, 5th ed. Bethesda, NIH Publications, 1991
Trainor KJ, Brisco MJ, Story CJ, Morley AA: Monoclonality in B-lymphoproliferative disorders detected at the DNA level. Blood 75:2220–2222, 1990
Wan JH, Sykes PJ, Orell SR, Morley AA: Rapid method for detecting monoclonality in B cell lymphoma in lymph node aspirates using the polymerase chain reaction. J Clin Pathol 45:420–423, 1992
Sukpanichnant S, Vnencak-Jones CL, McCurley TL: Determination of B-cellclonality in paraffin-embedded endoscopic biopsy specimens of abnormal lymphocytic infiltrates and gastrointestinal lymphoma by polymerase chain reaction. Am J Clin Pathol 102:299–305, 1994
Inagaki H, Nonaka M, Nagaya S, Tateyama H, Sasaki M, Eimoto T: Monoclonality in gastric lymphoma detected in formalin-fixed, paraffin-embedded endoscopic biopsy specimens using immunohistochemistry, in situhybridization, and polymerase chain reaction. Diagn Mol Pathol 4:32–38, 1995
Reed TJ, Reid A, Wallberg K, O'Leary TJ, Frizzera G: Determination of B-cell clonality in paraffin-embedded lymph nodes using the polymerase chain reaction. Diagn Mol Pathol 2:42–49, 1993
Osborne BM, Pugh WC: Practicality of molecular studies to evaluate small lymphocytic proliferations in endoscopic gastric biopsies. Am J Surg Pathol 16:838–844, 1992
Mies C: Molecular pathology of paraffin-embedded tissue. Current clinical application. Diagn Mol Pathol 1:206–211, 1992
Griesser H: Applied molecular genetics in the diagnosis of malignant non-Hodgkin's lymphoma. Diagn Mol Pathol 2:177–191, 1993
Sklar J: Antigen receptor genes: Structure, function, and techniques for analysis of their rearrangements. InNeoplastic Hematopathology. DM Knowles (ed). Baltimore, Williams & Wilkins, 1992, pp 215–244
Ratech H, Masih A: Sensitive detection of clonal antigen receptor gene rearrangements in non-Hodgkin's malignant lymphoma with an anchored polymerase chain reaction-based strategy. Am J Clin Pathol 100:527–533, 1993
Sioutos N, Bagg A, Michaud GY, Irving SG, Hartmann DP, Siragy H, Oliveri DR, Locker J, Cossman J: Polymerase chain reaction versus southern blot hybridization. Detection of immunoglobulin heavy-chain gene rearrangements. Diagn Mol Pathol 4:8–13, 1995
Yokota S, Hansen-Hagge TE, Ludwig WD, Reiter A, Raghavachar A, Kleihauer E, Bartram CR: Use of polymerase chain reactions to monitor minimal residual disease in acute lymphoblastic leukemia patients. Blood 77:331–339, 1991
Gribben JG, Freedman AS, Woo SD, Blake K, Shu RS, Free-man G, Longtine JA, Pinkus GS, Nadler LM: All advanced stage non-Hodgkin's lymphomas with a polymerase chain re-action amplifiable breakpoint of bcl-2 have residual cells containing the bcl-2 rearrangement at evaluation and after treatment. Blood 78:3275–3280, 1991
Sigal SH, Saul SH, Auerbach HE, Raffensperger E, Kant JA, Brooks JJ: Gastric small lymphocytic proliferation with immunoglobulin gene rearrangement in pseudolymphoma versus lymphoma. Gastroenterology 97:195–201, 1989
Eimoto T, Futami K, Naito H, Takeshita M, Kikuchi M. Gastric pseudolymphoma with monotypic cytoplasmic immunoglobulin. Cancer 55:788793, 1985
Galton DA, Catovsky DW, Wiltshaw E: Clinical Spectrum of lymphoproliferative diseases. Cancer 42:901–910, 1978
Wood GS, Weiss LM, Hu CH, Abel EA, Hoppe RT, Warnke RA, Sklar J: T-cell antigen deficiencies and clonal rearrange-ments of T-cell receptor genes in pagetoid reticulosis (Woringer-Kolopp disease ). N Engl J Med 318:164–167, 1988
LeBoit PE, Abel EA, Cleary ML, Hoppe RT, Williams ML, Wood GS, Parslow TG: Clonal rearrangement of the T-cell receptor beta gene in the circulating lymphocytes of erythrodermic follicular mucinosis. Blood 71:1329–1333, 1988
Jaworsky C, Cirillo-Hyland V, Petrozzi JW, Lessin SR, Murphy GF: Regressing atypical histiocytosis: Aberrant prothymocyte differentiation, T-cell receptor gene rearrangements, and nodal involvement. Arch Dermatol 126:1609–1616, 1990
Headington JT, Roth MS, Ginsburg D, Lichter AS, Hyder D, Schnitzer B: T-cell receptor gene rearrangement in regressing atypical histiocytosis. Arch Dermatol 123:1183–1187, 1987
Hytiroglou P, Phelps RG, Wattenberg DJ, Strauchen JA: Histiocytic cytophagic panniculitis: molecular evidence for a clonal T-cell disorder. J Am Acad Dermatol 27:333–336, 1992
Weiss LM, Wood GS, Trela M, Warnke RA, Sklar J: Clonal T-cell populations in lymphomatoid papulosis. Evidence of a lymphoproliferative origin for a clinically benign disease. N Engl J Med 315:475–479, 1986
Kadin ME, Vondeheid EC, Sako D, Clayton LK, Olbricht S: Clonal composition of T cells in lymphomatoid papulosis. Am J Pathol 126:13–17, 1987
Whittaker S, Smith N, Jones RR, Luzzatto L: Analysis of beta, gamma, and delta T-cell receptor genes in lymphomatoid papulosis: cellular basis of two distinct histologic subsets. J Invest Dermatol 96:786–</del>791, 1991
Zelickson BD, Peters MS, Muller SA, Thibodeau SN, Lust JA, Quam LM, Pittelkow MR: T-cell receptor gene rearrangement analysis: cutaneous T cell lymphoma, peripheral T cell lymphoma, and premalignant and benign cutaneous lymphoproliferative disorders. J Am Acad Dermatol 25:787–796, 1991
Mehregan DA, Gibson LE, Muller SA: Follicular mucinosis: Histopathologic review of 33 cases. Mayo Clin Proc 66:387–390, 1991
Weiss LM, Wood GS, Ellisen LW, Reynolds TC, Sklar J: Clonal T-cell populations in pityriasis lichenoideset varioliforms acuta (Mucha-Habe rmann disease ). Am J Pathol 126:417–421, 1987
Landa N, Zelickson BD, Peters MS, Muller SA, Pittelkow MR: Cutaneous lymphoma versus pseudolymphoma: gene rearrangement study of 21 cases with clinicopathologic correlation. J Invest Dermatol 96:569A, 1991
Rijlaarsdam U, Bakels V, van Oostveen LW, Gordijn RJ, Geerts ML, Meijer CJ, Willemze R: Demonstration of clonal immunoglobulin gene rearrangements in cutaneous B-cell lymphomas and pseudo-B-cell lymphomas: Differential diagnostic and pathogenetic aspects. J Invest Dermatol 99:749–754, 1992
Wood GS, Ngan BY, Tung R, Hoffman TE, Abel EA, Hoppe RT, Warnke RA, Cleary ML, Sklar J: Clonal rearrangements of immunoglobulin genes and progression to B cell lymphoma in cutaneous lymphoid hyperplasia. Am J Pathol 135:13–19, 1989
Doherty PJ, Yang SX, Laxer RM, Silverman ED, Inman R, Pan S: Evidence for clonal expansion of T cell receptor VgammaII1 T cells in the synovial fluid of patients with arthritis. J Immunol 149:295–299, 1992
Kossakowska AE, Eyton-Jones S, Urbanski SJ: Immunoglobulin and T-cell receptor gene rearrangements in lesions of mucosa-associated lymphoid tissue. Diagn Mol Pathol 2:233240, 1993
Lehman CM, Sarago C, Nasim S, Comerford J, Karcher DS, Garrett CT: Comparison of PCR with Southern hybridization for the routine detection of immunoglobulin heavy chain gene rearrangements. Am J Clin Pathol 103:171–176, 1995
Samoszuk M, Ramzi E, Ravel J: Disseminated persistent lymphoid hyperplasia containing Epste in-Barr virus and clonal rearrangements of DNA. Diagn Mol Pathol 2:57–60, 1993
Armes JE, Eades S, Southey MC, Ross BC, Carapetis JR, Chow CW, Venter DJ: Disseminated, multiclonal Epstein-Barr virus-associated lymphoproliferative disease in a patient with hematological and immunological anomalies. Diagn Mol Pathol 4:39–47, 1995
Calvert R, Randerson J, Evans P, Cawkwell R, Lewis F, Dixon MF, Jack A, Owen R, Shiach C, Morgan GJ: Genetic abnormalities during transition from Helicobacter-pylori-associated gastritis to low-grade MALToma. Lancet 345:26–27, 1995
Hsi ED, Greenson JK, Singleton TP, Siddiqui J, Schnitzer B, Ross CW: Detection of immunoglobulin heavy chain gene rearrangements by polymerase chain reaction in chronic active gastritis associted with Helicobacter pylori. Hum Pathol 27:290296, 1996
Weiss LM, Spagnolo DV: Assessment of clonality in lymphoid proliferations. Am J Pathol 142:1679–1682, 1993
Diaz-Cano S: PCR-based alternative for diagnosis of immunoglobulin heavy chain gene rearrangement. Principles, practice, and polemics. Diagn Mol Pathol 5:3–9, 1996
Inghirami G, Szablocs MJ, Yee HT, Corradini P, Cesarman E, Knowles DM: Detection of immunoglobulin gene re arrange-ment of B cell non-Hodgkin's lymphomas and leukemias in fresh, unfixed and formalin-fixed, paraffin-embedded tissue by polymerase chain reaction. Lab Invest 68:746757, 1993
Liang R, Chan V, Chan TK, Wong T, Chiu E, Lie A, Todd D: Detection of immunoglobulin gene rearrangements in lymphoid malignancies of B-cell lineage by seminested polymerase chain reaction gene amplification. Am J Hematol 43:24–28, 1993
Slack DN, McCarthy KP, Wiedemann LM, Sloane JP: Evaluation of sensitivity, specificity, and reproducibility of an optimized method for detecting clonal rearrangements of immunoglobulin and T-cell receptor genes in formalin-fixed, paraffin-embedded sections.Diagn Mol Pathol 2:223232, 1993
Yamada M, Hudson S, Tournay O, Bittenbender S, Shane SS, Lange B, Tsujimoto Y, Caton AJ, Rovera G: Detection of minimal disease in hematopoietic malignancies of the B-cell lineage by using third-complementarity-determining region (CDR-III)-specific probes. Proc Natl Acad Sci USA 86:5123–5127, 1989
Deane M, McCarthy KP, Wiedemann LM, Norton JD: An improved method for detection of B-lymphoid clonality by polymerase chain reaction. Leukemia 5:726–730, 1991
Medeiros LJ, Weiss LM: The utility of the polymerase chain reaction as a screening method for the detection of antigen receptor gene rearrangements. Hum Pathol 25:1261–1263, 1994
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Weston, A.P., Banerjee, S.K., Horvat, R.T. et al. Specificity of Polymerase Chain Reaction Monoclonality for Diagnosis of Gastric Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma (Direct Comparison to Southern Blot Gene Rearrangement). Dig Dis Sci 43, 290–299 (1998). https://doi.org/10.1023/A:1018842002926
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DOI: https://doi.org/10.1023/A:1018842002926