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T Henni, P Gaulard, M Divine, JP Le Couedic, D Rocha, C Haioun, Z Henni, JP Marolleau, Y Pinaudeau and M Goossens
INSERM U.91, Service d'Hematologie Clinique, Creteil, France.
We examined 91 specimens (from 87 patients) for the expression of B- cell-
and T-cell-associated differentiation antigens and rearrangements of the Ig
and beta-chain of the T-cell (beta-TCR) genes. Of these, 74 were
representative of various histologic subtypes of non-Hodgkin's lymphoma and
related disorders, 11 of Hodgkin's disease, and 6 of reactive lymphoid
hyperplasia. An Ig gene clonal rearrangement correlated to a monotypic
(kappa/lambda) phenotype in 32 of 33 histologically defined lymphoma
samples. The genotypic analysis also confirmed clonality in six of seven
malignant diffuse lymphomas that were nonmonotypic but expressed pan-B
antigens; in four, more than one clone was detected within individual
tumors. A beta-TCR clonal rearrangement was found in 19 of 19 tumor samples
considered as malignant T-cell lymphoma on the basis of histopathology and
of the CD3- positive phenotype of tumoral cells, and in two cases of
CD3-positive lymphomatoid disorders. A loss of pan-T antigens (CD7, CD5,
CD2, CD4/CD8) was observed in all but three of these CD3-positive samples.
Such an incomplete T-cell phenotype always correlated to the presence of a
monoclonal process as revealed by genotypic analysis. DNA analysis was the
only way to demonstrate clonality in other samples with either a
polymorphous (partial involvement, pseudolymphoma, angioimmunoblastic
lymphodenopathy [AILD]) or an undifferentiated (large cell anaplastic)
phenotype. It is concluded that although in the majority of cases
immunophenotyping alone provides criteria adequate for the diagnosis of
lymphoid malignancy, in some, particularly polymorphous or large cell
anaplastic processes, genetic probe analysis was additionally
discriminative.
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