The role of gene rearrangements for antigen receptors in the diagnosis of lymphoma obtained by fine-needle aspiration: A study of 63 cases with concomitant immunophenotyping

R. L. Katz, C. Hirsch-Ginsberg, C. Childs, R. Dekmezian, T. Fanning, N. Ordonez, F. Cabanillas, N. Sneige

    Research output: Contribution to journalArticlepeer-review

    Abstract

    To assess the efficacy of performing genotyping in addition to immunophenotyping as an adjunct to cytologic diagnosis, 63 consecutive patients with fine-needle aspirates of lymphoproliferative lesions who had concurrent immunophenotyping and genotyping performed on fine-needle aspirate cell suspensions were studied. Thirty-nine of 63 specimens (62%) that appeared to contain non-Hodgkin's lymphoma and that proved to be of B-cell lineage by genotyping were accurately phenotyped and shown to be monotypic for immunoglobulin light chains by cell suspension immunocytochemistry. Genotyping facilitated lineage assignment and/or confirmed clonality in 17 of 63 specimens (27%) that were difficult to determine based on morphologic data. These include cases of atypical lymphoid proliferations with polyclonal or inconclusive markers (n = 6), peripheral T-cell lymphoma (n = 3), extracutaneous mycosis fungoides (n = 1), lymphoblastic lymphoma (n = 4), null cell lymphoma (n = 1), and specimens with equivocal or technically unsatisfactory markers (n = 2). Based on these results, it is proposed that genotyping for lineage assignment and/or clonality be performed to include cases of atypical lymphoid proliferations, T-cell malignant neoplasms, lymphoid malignant neoplasms with equivocal markers, and differentiation of lymphoid from nonlymphoid neoplasms. Genotyping by antigen-receptor gene rearrangement appears to be redundant in cases with mature B-cell phenotypes that demonstrate monoclonality by immunophenotyping.
    Original languageEnglish
    Pages (from-to)479-490
    Number of pages11
    JournalAmerican journal of clinical pathology
    Volume96
    Issue number4
    Publication statusPublished - 1991

    Keywords

    • Fine-needle aspiration
    • Gene rearrangements
    • Lymphoma

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