A 70-yr-old woman was hospitalized with a history of dry cough. Bronchial endoscopy and transbronchial lung biopsy were performed. However, the findings of histopathology and immunohistochemistry were not sufficient to decide whether the lesion was benign or malignant, because of the presence of crush artifacts in the biopsy specimens. We performed B-cell clonality studies using BIOMED-2 multiplex PCR (InVivoScribe Technologies, USA) to detect clonal rearrangements in the immunoglobulin gene. The results of multiplex PCR showed clonal rearrangements of both kappa and lambda immunoglobulin light chain genes. The findings of immunochemistry revealed that the lesion expressed lambda light chain, but not kappa light chain. Based on the clinical, pathologic, and molecular findings, this case was diagnosed as pulmonary MALT lymphoma. We report the first case in Korea of lambda-expressing MALT lymphoma that is shown to have dual clonal rearrangements of kappa and lambda immunoglobulin light chain gene by multiplex PCR.
Aged ; Female ; *Gene Rearrangement, B-Lymphocyte, Light Chain ; Humans ; Immunoglobulin kappa-Chains/*genetics ; Immunoglobulin lambda-Chains/*genetics ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/genetics/pathology ; Polymerase Chain Reaction

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

No abstract available.
Antibodies, Monoclonal, Murine-Derived/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; B-Cell-Specific Activator Protein/metabolism ; Bone Marrow/metabolism/*pathology ; Cyclophosphamide/therapeutic use ; Doxorubicin/therapeutic use ; Endoscopy, Digestive System ; Female ; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor ; Genetic Loci ; Humans ; Liver/metabolism/pathology ; Lymphocytes/cytology/immunology ; Lymphoma, Large B-Cell, Diffuse/complications/*diagnosis/drug therapy ; Lymphoma, T-Cell, Peripheral/complications/*diagnosis/drug therapy ; Middle Aged ; Prednisone/therapeutic use ; Receptors, Antigen, T-Cell, gamma-delta/genetics ; Tomography, X-Ray Computed ; Vincristine/therapeutic use

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

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

No abstract available.
Bone Marrow/metabolism/pathology ; DNA Mutational Analysis ; Gene Rearrangement, T-Lymphocyte ; Humans ; Immunophenotyping ; Infant ; Lymphohistiocytosis, Hemophagocytic/*diagnosis ; Male ; Membrane Proteins/chemistry/genetics ; Polymorphism, Single-Stranded Conformational ; Republic of Korea ; T-Lymphocytes/immunology/*metabolism

No abstract available.
Gene Rearrangement* ; Lung ; Lymphoma ; Polymerase Chain Reaction ; T-Lymphocytes*

No abstract available.
Exons ; Gene Rearrangement ; Immunoglobulin Heavy Chains ; Immunoglobulins ; Leukemia, Lymphoid

Early diagnosis of acute promyelocytic leukemia (APL) depends primarily on morphological recognition before the presence of t(15;17) or PML-RAR gene rearrangement is confirmed. But the diagnosis is difficult to be made, if typical APL morphologic features are not found. Here, we describe a 32- year old man who had been diagnosed as APL. He relapsed with AML M1 like phenotype, lacking the typical features of APL. At relapse, t(15;17) and PML-RAR alpha gene rearrangement were detected. After 14 days of chemotherapy and all-trans retinoic acid, the phenotype changed from the AML M1 like features to the typical hypergranular APL. Awareness of atypical morphologic subtypes found in APL is important. And identification of t(15;17) or PML/RAR alpha rearrangement will be helpful in diagnosis of atypical APL.
Diagnosis ; Drug Therapy ; Early Diagnosis ; Gene Rearrangement ; Leukemia, Promyelocytic, Acute* ; Phenotype ; Recurrence* ; Tretinoin

Cutaneous pseudolymphoma (CPL) has a microscopic appearance that resembles that of cutaneous lymphoma, but shows a clinically benign course. The differential diagnosis of CPL with cutaneous lymphoma is very important because clinical outcomes of them are quite different. We herein describe two cases of B-cell pseudolymphoma, which were difficult to differentiate from cutaneous B-cell lymphlma. All of two cases, Polymerase chain reaction of immunoglobulin heavy chain gene rearrangement showed polyclonal pattern.
B-Lymphocytes* ; Diagnosis, Differential ; Gene Rearrangement ; Immunoglobulin Heavy Chains ; Lymphoma ; Polymerase Chain Reaction ; Pseudolymphoma*