Abstract
The morphological classification of angioimmunoblastic lymphadenopathy (AILD) or T-cell lymphoma of AILD-type (AILD-TCL) is still a subject of considerable difficulty and controversy. The aim of the current study was to examine the value of clinical, morphological, immunohistochemical variables in paraffin-embedded tissues in predicting the clonality of the respective lesion. Fifteen lymph node biopsies derived from 13 patients from Chengdu, China, were diagnosed as AILD or AILD-TCL and included in this study. The specimes were examined using a panel of monoclonal antibodies and a scoring system of morphological features. Clonality of the paraffin-embedded material was investigated using a novel polymerase chain reaction-technique to amplify rearranged T-cell receptor (TCR)-γ sequences. Additional experiments were carried out to investigate the presence of clonal rearrangements of the immunoglobulin heavy chain (IgH) locus. We found clonal rearrangements of the TCR-γ locus in 9 out of 15 lymph node biopsies. In 3 patients, the predominant cell clones carried clonal IgH and TCR-γ rearrangements whereas 1 patient with polyclonal TCR-γ pattern displayed IgH-monoclonality. The statistical evaluation of morphological and immunohistochemical data indicated that no single variable was able significantly to predict the clonality of the lesion. Furthermore, demonstrable clonality for the TCR-γ or the IgH loci of a lesion did not correlate with a bad clinical course. Our data correlate with findings of other studies investigating AILD-TCL in Caucasian populations.
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Albrecht S, Bruner JM, Segall GK (1993) Immunoglobulin heavy chain rearrangements in primary brain lymphomas. A study using PCR to amplify CDR-III. J Pathol 169:297–302
Anagnostopoulos I, Hummel M, Finn T, Tiemann M, Korbjuhn P, Dimmler C, Gatter KC, Dallenbach F, Parwaresch MR, Stein H (1992) Heterogeneous Epstein-Barr virus infection patterns in peripheral T-cell lymphoma of angioimmunoblastic lymphadenopathy type. Blood 80:1804–1812
Aozasa K, Ohsawa M, Fujita MQ, Kanayama Y, Tominaga N, Yonezawa T, Matsubuchi T, Hirata M, Uda H, Kanamaru A, Inada E, Nakaqama S (1989) Angioimmunoblastic lymphadenopathy: review of 44 patients with emphasis on prognostic behaviour. Cancer 63:1625–1629
Bornkamm GW, Stein H, Lennert K, Rüggeberg F, Bartels H, Hausen H zur (1976) Attempts to demonstrate virus-specific sequences in human tumors. IV. EB viral DNA in European Burkitts lymphoma and immunoblastic lymphadenopathy with excessive plasmacytosis. Int J Cancer 17:177–181
Cossman J, Zehnbauer B, Garrett CT, Smith LJ, Williams M, Jaffe ES, Hanson LO, Love J (1991) Gene rearrangements in the diagnosis of lymphoma/leukemia — guidelines for use based on a multiinstitutional study. Am J Clin Pathol 95:347–354
Deane M, Norton JD (1990) Detection of immunoglobulin gene rearrangement in B lymphoid malignancies by polymerase chain reaction gene amplification. Br J Haematol 74:251–256
Diss TC, Peng H, Wotherspoon AC, Isaacson PG, Pan L (1993) Detection of monoclonality in low-grade B-cell lymphomas using the polymerase chain reaction is dependent on primer selection and lymphoma type. J Pathol 169:291–296
Feller AC, Griesser H, Schilling C von, Wacker HH, Dallenbach F, Bartels H, Kruse R, Mak TW, Lennert K (1988) Clonal gene rearrangement patterns correlate with immunophenotype and clinical parameters in patients with angioimmunoblastic lymphadenopathy. Am J Pathol 133:549–557
Forster A, Huck S, Ghanem M, Lefranc MP, Rabbitts TH (1987) New subgroups in the human T cell rearranging Vγ gene locus. EMBO J 6:1945–1950
Frizzera G, Moran EM, Rappaport H (1974) Angioimmunoblastic lymphadenopathy with dysproteinemia. Lancet 1:1070–1073
Frizzera G, Kaneko Y, Sakurai M (1989) Angioimmunoblastic lymphadenopathy and related disorders: a retrospective look in search of definition. Leukemia 3:1–5
Fujita K, Fukuhara S, Nasu K, Yamabe H, Tomono H (1986) Recurrent chromosome abnormalities in adult T-cell lymphomas of peripheral T-cell origin. Int J Cancer 37:517–524
Goudie RB, Karim SN, Millis K, Alcorn M, Lee FS (1990) A sensitive method of screening for dominant T cell clones by amplification of T cell gamma gene rearrangements with the polymerase chain reaction. J Pathol 162:191–196
Griesser H, Feller A, Lennert K, Minden M, Mak TW (1986) Rearrangement of the b chain of the T cell antigen receptor and immunoglobulin genes in lymphoproliferative disorders. J Clin Invest 78:1179–1184
Hell K, Lorenzen J, Hansmann ML, Fellbaum C, Busch R, Fischer R (1993) Expression of the proliferating cell nuclear antigen in different types of Hodgkin's disease. Am J Clin Pathol 99:598–603
Hook S, Dariavach P, LeFranc MP (1988) Variable region genes in the human T-cell rearranging gamma (TRG) locus: V-J junction and homology with mouse genes. EMBO J 7:719–726
Knecht H, Odermatt BF, Hayoz D, Kühn L, Bachmann F (1989) Polyclonal rearrangements of the T-cell receptor β-chain in fatal angioimmunoblastic lymphadenopathy. Br J Haematol 73:491–496
Knecht H, Sahli R, Shaw P, Meyer C, Bachmann E, Odermatt BF, Bachmann F (1990) Detection of Epstein-Barr virus DNA by polymerase chain reaction in lymph node biopsies from patients with angioimmunoblastic lymphadenopathy. Br J Haematol 75:610–614
Küppers R, Zhao M, Rajewsky K, Hansmann ML (1993) Detection of clonal B cell populations in paraffin-embedded tissues. Am J Pathol 143(1):230–239
Lennert K, Knecht H, Brukert M (1979) Vorstadien maligner Lymphome. Verh Dtsch Ges Pathol 63:170–196
Lorenzen J, Jux G, Zhao-Höhn M, Klöckner A, Fischer R, Hansmann ML (1994) Detection of T-cell clonality in paraffin-embedded tissues. Diagn Mol Pathol 3:93–99
Lukes RJ, Trindle BH (1975) Immunoblastic lymphadenopathy: a hyperimmune entity resembling Hodgkin's disease. N Engl J Med 292:1–8
McCarthy KP, Sloane JP, Kabarowski JHS, Matutes E, Wiedemann LM (1991) The rapid detection of clonal T-cell proliferations in patients with lymphoid disorders. Am J Pathol 138:821–828
McCarthy KP, Sloane JP, Kabarowski JHS, Wiedemann LM (1992) A simplified method of detection of clonal rearrangements of the T-cell receptor-γ chain gene. Diagn Mol Pathol 1:173–179
Michelson AM, Blake CCF, Evans ST, Orkin SH (1985) Structure of the human phosphoglycerate kinase gene and the intron-mediated evolution and dispersal of the nucleotide binding domain. Proc Natl Acad Sci USA 82:6965–6969
Nakamura S, Suchi T (1991) A clinicopathologic study of node-based, low-grade, peripheral T-cell lymphoma — angioimmunoblastic lymphoma, T-zone lymphoma, and lympho-epithelioid lymphoma. Cancer 67:2565–2578
O'Connor NTJ, Crick JA, Wainscoat JS, Gatter KC, Stein H, Falini B, Mason DY (1986) Evidence for monoclonal T lymphocyte proliferation in angioimmunoblastic lymphadenopathy. J Clin Pathol 39:1229–1232
Ott G, Ott MM, Feller AC, Seidl S, Müller-Hermelink HK (1992) Prevalence of Epstein-Barr virus DNA in different T-cell lymphoma entities in a European population. Int J Cancer 51:562–567
Radaszkiewicz T, Lennert K (1975) Lymphogranulomatosis X: Klinisches Bild, Therapie und Prognose. Dtsch Med Wochenschr 100:1157–1163
Shimoyama M, Minato K, Saito H, Takenaka T, Watanabe S, Nagatani T, Naruto M (1979). Immunoblastic lymphadenopathy (IBL)-like T-cell lymphoma. Jpn J Clin Oncol 9 [Suppl 1]:347–356
Stansfeld AG, Diebold J, Kapanci Y, Kelenyi G, Lennert K, Mioduszewska O, Noel H, Rilke F, Sundstrom C, Unnik JAM van, Wright DH (1988) Updated Kiel classification for lymphomas. Lancet i:292–293
Takagi N, Nakamura S, Ueda R, Osada H, Obata Y, Kitoh K, Suchi T (1992) A phenotypic and genotypic study of three node-based, low-grade peripheral T-cell lymphomas: angioimmunoblastic lymphoma, T-zone lymphoma, and lympho-epithelioid lymphoma. Cancer 69:2571–2582
Tobinai K, Minato K, Ohtsu K, Mukai K, Kagami Y, Miwa M, Watanabe S, Shimoyama M (1988) Clinicopathologic, immunophenotypic, and immunogenotypic analyses of immunoblastic lymphadenopathy-like T-cell lymphoma. Blood 72:1000–1006
Volkenandt M, Soyer HP, Kerl H, Bertino JR (1991) Development of a highly specific and sensitive molecular probe for detection of cutaneous lymphoma. J Invest Dermatol 97(1):137–140
Watanabe S, Sato Y, Shimoyama M, Minato K, Shimosato Y (1986) Immunoblastic lymphadenopathy, angioimmunoblastic lymphadenopathy, and IBL-like T-cell lymphoma: a spectrum of T-cell neoplasia. Cancer 58:2224–2232
Weiss LM, Strickler JG, Dorfman RF, Horning SJ, Warnke RA, Sklar J (1986) Clonal T-cell populations in angioimmunoblastic lymphadenopathy and angioimmunoblastic lymphadenopathy-like lymphoma. Am J Pathol 122:392–397
Weiss LM, Jaffe ES, Liu XF, Chen YY, Shibata D, Medeiros LJ (1992) Detection and localization of Epstein-Barr viral genomes in angioimmunoblastic lymphadenopathy and angioimmunoblastic-like lymphoma. Blood 79:1789–1795
Zhou XG, Hamilton-Dutoit SJ, Yan QH, Pallesen G (1994) High frequency of Epstein-Barr virus in Chinese peripheral T-cell lymphoma. Histopathology 24:115–122
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Lorenzen, J., Zhao-Höhn, M., Wintzer, C. et al. Angioimmunoblastic lymphadenopathy type of T-cell lymphoma and angioimmunoblastic lymphadenopathy: a clinicopathological and molecular biological study of 13 Chinese patients using polymerase chain reaction and paraffin-embedded tissues. Vichows Archiv A Pathol Anat 424, 593–600 (1994). https://doi.org/10.1007/BF00195772
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DOI: https://doi.org/10.1007/BF00195772