The Relationship Between Primary Gastric B-cell Lymphoma and Immunoglobulin Heavy Chain (IgH) Gene Rearrangement – A Histopathological Study of Primary Gastric Lymphomas

Department of Pathology, Saga Medical School, Saga, Japan.
Pathology - Research and Practice (Impact Factor: 1.4). 02/2003; 199(10):647-58. DOI: 10.1078/0344-0338-00476
Source: PubMed


The aim of this study was to review our primary gastric lymphoma cases according to the new WHO classifications and to investigate the histopathological features of B-cell lymphomas. In addition, B-cell monoclonality was analyzed for immunoglobulin heavy chain (IgH) gene rearrangement using the polymerase chain reaction at the site of the lymphoma lesion, transitional lesion, and the non-lymphoma lesion. Specimens resected from 31 primary gastric lymphomas were examined. There were 28 cases (90.3%) of B-cell lymphoma and three cases (9.7%) of T-cell lymphoma. The B-cell lymphomas were classified as low-grade mucosa-associated lymphoid tissue (MALT) lymphoma (LGML) (9%), high-grade MALT lymphoma (HGML) (42%), and diffuse large B-cell lymphoma (DLBCL) (29%). Histopathologically, lymphoepithelial lesions (LEL) were higher in LGML (100%) than in DLBCL (22%), with statistical significance (p < 0.05). A monoclonal pattern of IgH rearrangement was detected in LGML (50.0%), HGML (60.0%), and DLBCL (80.6%), with a statistically significant difference between LGML and DLBCL (p < 0.01). The IgH monoclonal pattern may reflect the gross appearance of lymphoma or the lymphoma infiltration depth. Superficial spreading and shallow growth in LGML may correspond to an oligoclonal pattern, and mass-forming and deep invasive growth in DLBCL may correspond to a more monoclonal pattern.

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    • "If DNA shows distinct band of the same electrophoresis mobility, the sample is defined as monoclonal. Normal DNA and reactive DNA hyperplasia are polyclonal with smear bands [9]. It's said that about 80% of B-NHL have IgH monoclonal rearrangement and 30% of T-NHL have TCR monoclonal rearrangement [10].The latest study reports that positive ratio could be up to 99% (B-NHL)and 94% (T-NHL) using multiplex primers [11]. "
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