Gene rearrangement analysis using Southern-blot hybridization technique is a standard method for evaluating clonal receptor gene rearrangement. Both clonality and lineage can be identified in lymphoid neoplasms by the demonstration of one or more rearranged antigen receptor genes of the immunoglobulin supergene family-immunoglobulin and T-cell receptor genes. To evaluate the diagnostic applicability of antigen receptor gene rearrangements in the diagnosis of malignant lymphomas and leukemias, the authors performed a gene rearrangement analysis of 54 cases by southern blot hybridization technique. One or two clonally rearranged bands were detected in the malignant lymphomas and in the lymphoblastic leukemias with a false-negative rate of 13.8%. No clonal, rearranged band was detected in benign reactive hyperplasias, carcinomas or non-lymphocytic leukemias. Rearrangement analysis could resolve the lineage, clonality and stage of differentiation of malignant lymphoid neoplasms.
Gene Rearrangement ; *Gene Rearrangement, T-Lymphocyte ; *Genes, Immunoglobulin ; Human ; Leukemia/*genetics/immunology ; Lymphoma/*genetics/immunology ; Support, Non-U.S. Gov't

OBJECTIVETo explore the feasibility of detecting lymphoma with the application of BIOMED-2 standardized immunoglobulin/T cell receptor (IG/TCR) gene rearrangement system in formalin fixed paraffin-embedded (FFPE) tissue samples, and to discuss the relationship between the longest amplification fragment of extracted DNA and positive detection rate of different IGH V-J primers.

METHODSDNA was extracted from 50 cases of FFPE tissue samples. Multiplex-PCR amplifications were performed and then the IG/TCR gene rearrangements were analyzed using BIOMED-2 standardized clonality analysis system.

RESULTS(1)When the DNA concentration was diluted to 50-100 ng/μl from 100-500 ng/μl, the proportion of the longest amplification fragment (300-400 bp) of DNA was improved from 10.0% to 90.0% in 30 cases of diffuse large B cell lymphoma (DLBCL) wax roll samples (P<0.01). The positive rate of IGH+IGK was increased from 46.7% to 83.3%, the difference was statistically significant (P=0.006). The lengths of the longest amplification fragments of DNA were all longer than 300 bp in the paraffin section samples of DLBCL. The positive rate of IGH+IGK of these samples was 96.7%. The difference of the positive rate of IGH+IGK between the wax roll samples and the paraffin section samples had no statistical significance (P=0.195). (2)When the concentration of DNA was high, most of the longest amplification fragments of extracted DNA were 100 bp or 200 bp, and the detection rate of short fragment IGH FR3 was more stable than that of long fragment IGH FR1. (3)The clonality analysis of TCRG+TCRB in all 13 cases of peripheral T cell lymphoma samples showed positive results, while no positive IG/TCR clones were found in 7 cases of reactive lymphoid tissue hyperplasia in control group.

CONCLUSIONDilution of DNA is the only method to improve not only the proportion of longest fragment amplification but also the detection rate of clonality. The detection rate of IGH FR3 would not be affected by the concentration of DNA. The application of BIOMED-2 standardized IG/TCR gene rearrangement system in FFPE tissue samples plays an important role in the lymphoma diagnosis.

Gene Rearrangement, T-Lymphocyte ; Humans ; Lymphoma ; diagnosis ; genetics ; Paraffin Embedding ; V(D)J Recombination

OBJECTIVETo establish a sensitive and effective method for detection of immunoglobulin and T-cell receptor (Ig/TCR) gene rearrangement,and to explore its role in diagnosis and differential diagnosis of lymphoproliferative disorders.

METHODSFifty-eight lymphoid tissue samples from 54 patients with lymphoproliferations were evaluated by the novel BIOMED-2 multiplex polymerase chain reaction (PCR) for antigen receptor genes rearrangement.

RESULTSMultiplex PCR demonstrated monoclonal Ig/TCR gene rearrangements in 22 of 25 (88.0%) B-cell malignancies and 8 of 15 (53.3%) T-cell malignancies. Among 17 benign lymphoproliferations confirmed histopathologically, polyclonal rearrangements were detected in 14 cases (82.4%). In total, the clonality analysis and the final clinico-histopathological diagnosis were concordant in 77.2%. Combination detection of Iglambda and TCR delta gene rearrangements did not increase the detection rate of monoclonal rearrangement of Ig/TCR, but might help to the detection of Iglambda+ or TCR delta+ lymphomas.

CONCLUSIONThe novel BIOMED-2 multiplex PCR strategy is a rapid, reliable and sensitive approach to detecting clonality in suspected lymphoproliferations, especially in atypical cases.

Female ; Gene Rearrangement, B-Lymphocyte, Light Chain ; Gene Rearrangement, T-Lymphocyte ; Humans ; Lymphoproliferative Disorders ; diagnosis ; genetics ; Male ; Polymerase Chain Reaction ; methods ; Sensitivity and Specificity

Diagnosis, Differential ; Gene Rearrangement, B-Lymphocyte ; Gene Rearrangement, T-Lymphocyte ; Humans ; Lymphoma ; diagnosis ; genetics ; Lymphoma, Follicular ; diagnosis ; genetics ; Lymphoproliferative Disorders ; diagnosis ; genetics ; Polymerase Chain Reaction ; methods

To observe the expression and clonal expansion of TCR Vbeta subfamily T cells induced by AML-M(2a) cells in vivo and in vitro, complementary determining region 3 (CDR3) of TCR beta with variable region genes was amplified by using RT-PCR in both peripheral blood mononuclear cells (PBMNC) and T cells from mixed lymphocyte and tumor culture (MLTC) from four AML-M(2a) patients. The positive products were further analyzed to identify the clonality of T cells by genescan. The results showed that the similarity distribution of TCR Vbeta subfamily T cells was found Vbeta in PBMNC and MLTC. One or two clonality expansions of T cells could be found in predominant TCR Vbeta subfamily T cells induced by A ML-M2a cells from 3 cases in vivo and in vitro. It was concluded that clonal expansion of TCR Vbeta subfamily T cells stimulated selectively by AML-M(2a) cells may be a specific immune response of patient's T cells to AML-M(2a) cells associated antigen. The clonal proliferation of TCR Vbeta subfamily T cells were affected somewhat by environmental difference in vivo and in vitro.
Gene Rearrangement, T-Lymphocyte ; Genes, T-Cell Receptor beta ; Humans ; Leukemia, Myeloid, Acute ; immunology ; Lymphocyte Activation ; Reverse Transcriptase Polymerase Chain Reaction ; T-Lymphocytes ; immunology

CD20 positive T cell lymphoma is a rare condition that is associated with the coexpressions of CD20 and T cell markers, such as, CD3, CD5, or UCHL-1. Positivity for CD20 in this tumor represents an aberrant immunophenotype, but the presence of monoclonal T cell receptor (TCR) gene rearrangements and negativity for immunoglobulin heavy chain gene rearrangement indicate that this tumor is a T cell lymphoma. The majority of cases of CD20 positive T cell lymphoma have been reported as immature peripheral T cell lymphoma not otherwise specified. However, we believe that this disease is likely to be re-listed as a new disease entity after its pathogenesis has been elucidated and more cases have been evaluated. Here, we present a case of peripheral T cell lymphoma coexpressing CD20 and T cell markers with a demonstrable TCR gene rearrangement, in a patient who had been misdiagnosed as having B cell type lymphoma 4 years previously. We hypothesize that in this case initially circulating normal CD20+ T cell subsets underwent neoplastic transformation and CD20 positive T cell lymphoma subsequently developed in the lymph node, and then recurred in the skin due to systemic disease or metastasized from the nodal disease.
Gene Rearrangement ; Genes, T-Cell Receptor ; Humans ; Immunoglobulin Heavy Chains ; Lymph Nodes ; Lymphoma ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Receptors, Antigen, T-Cell ; Skin ; T-Lymphocyte Subsets

OBJECTIVETo evaluate the significance of T-cell antigen receptor (TCR) gene rearrangement among patients with acquired pure red cell aplastic anemia (A-PRCA).

METHODSFor 16 patients with A-PRCA, an immunosuppressive regimen based on cyclosporin A (CsA) was applied. Rearrangement of the TCR gene was detected by PCR, and T lymphocyte subsets in peripheral blood specimens was detected with flow cytometry.

RESULTSFive patients had presented with TCR clonal rearrangement and were positive for both TCR γ and TCR δ. The blood of 13 patients have returned to normal with the treatment, which included 3 cases with bone marrow returning to normal. In 7 cases, the red cell hyperplasia of bone marrow is still down, but has increased with the treatment. Three patients were close to cure, 7 showed remission, 3 were improved, but 3 were ineffective. The rate of effective treatment in those with TCR rearrangement (2/5) was significantly lower than that those without (11/11, chi-square=8.123, P < 0.05). Compared with those without the TCR gene rearrangement, the Th cells and proportion of Th/Ts were significantly lower, while the Ts cell (CD3+CD8+) were significantly higher in those with the rearrangement (P < 0.05).

CONCLUSIONTCR gene rearrangement may play a role in the pathogenesis of A-PRCA. CsA is effective for the treatment of A-PRCA, but patients presenting clonal TCR gene rearrangement may response poorly to the treatment.

Adult ; Aged ; Female ; Gene Rearrangement, T-Lymphocyte ; Humans ; Male ; Middle Aged ; Red-Cell Aplasia, Pure ; etiology ; genetics ; immunology

OBJECTIVETo evaluate the significance of immunoglobulin heavy chain (IgH) gene rearrangement for B-cell lymphoma and T-cell receptor (TCR) gene rearrangement for T-cell lymphoma and NK/T-cell lymphoma in diagnosing and typing of primary non-Hodgkin's lymphoma (NHL) in nasal cavity.

METHODSSemi-nested polymerase chain reaction ( PCR) with two pairs of primers was used to detect monoclonal IgH gene rearrangement in paraffin-embedded tissues from 11 patients with B-cell lymphoma, and one-stepped PCR with two pairs of primers was used to detect T-cell receptor gene rearrangement from 23 patients with NK/T-cell lymphoma and 20 patients with T-cell lymphoma. Ten patients with nasal polyp were detected with all the primers by PCR respectively.

RESULTSAmong the 54 patients with an evaluable PCR results, 10 of 11 (90. 9% ) B-cell lymphomas were positive for monoclonal IgH gene rearrangement, 17 of 20 (85. 0% ) T-cell lymphomas and 10 of 23 (43. 5% ) NK/T-cell lymphomas were positive for monoclonal TCR gene rearrangement. Ten patients with nasal polyp were negative for all detection.

CONCLUSIONSDetecting gene rearrangement was an efficient method in auxiliary diagnosing and typing of primary NHL in nasal cavity; Using semi-nested PCR or one-stepped PCR with two pairs of primers can enhance the positive rate of gene rearrangement detection.

Adolescent ; Adult ; Aged ; Child ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Gene Rearrangement, T-Lymphocyte ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; pathology ; Male ; Middle Aged ; Nasal Cavity ; Nose Neoplasms ; diagnosis ; pathology ; Young Adult

NK-cell lymphoma, distinct clinicopathologic entity, almost always occurs in the naso-sinal region. NK-cell lymphomas of other extranodal sites have also been recognized in previous case reports, but very rare. As far as we know, only four cases of primary pulmonary NK-cell lymphoma were reported worldwide. We experienced a case of primary pulmonary NK-cell lymphoma. A 54-year-old man was admitted because of cough and chest discomfort. The chest CT shows multifocal ground-glass and nodular opacities in both lungs. Video Assisted Thoracoscopy (VATS) was performed to assess the lung lesion. The tumor cells were characterized by cytoplasmic CD3 (+), CD56 (+), T-cell receptor antigen (-), Epstein-Barr Virus (+) and T-cell gene rearrangement (-), These findings were compatible with NK-cell lymphoma. So we performed the whole body Flurodeoxyglucose-Positron Emission Tomography (FDG-PET) to exclude any other lesion. The FDG-PET showed multiple hypermetabolic lesions only located in both lungs. The patient underwent 6 cycles of chemotherapy according to a CHOP regimen. Now his disease state is complete remission. To our knowledge, this is the first case of primary pulmonary NK-cell lymphoma in Korea.
Cough ; Cytoplasm ; Drug Therapy ; Gene Rearrangement, T-Lymphocyte ; Herpesvirus 4, Human ; Humans ; Korea ; Lung ; Lymphoma* ; Middle Aged ; Receptors, Antigen, T-Cell ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed

For a long time, thymic function could not be monitored, as a consequence of the absence of adequate technology to detect recent thymic emigrants from naive T cells. T cell differentiation in the thymus is characterized by T cell receptor (TCR) rearrangement. During the rearrangement of TCRalpha gene segments, the deltaRec and psiJalpha rearrange to each other to delete the TCRdelta gene and form an extrachromosomal DNA circles, referred to as signal joint T cell receptor excision DNA circles (sjTRECs) or TRECs. TRECs are assumed to have a high stability, they can not multiply and consequently are diluted during T cell proliferation. It was recently suggested that quantitative detection of TRECs would allow for direct measurement of thymic output. In this review TRECs quantification is a powerful method to evaluate the thymic output function in both health and disease, including hematopoietic stem cell transplantation, hematopoietic malignancies, HIV infection and autoimmune disease, and so on is described.
Animals ; Cell Differentiation ; Cell Movement ; Gene Rearrangement, T-Lymphocyte ; HIV Infections ; immunology ; Humans ; Immunity ; Neoplasms ; immunology ; T-Lymphocytes ; physiology ; Thymus Gland ; physiology