Molecular evidence of bone marrow involvement in advanced case ot Tgammadelta lymphoma with secondary myelofibrosis

We describe the case of a middle-aged man with long indolent course of generalized Tgammadelta lymphoma. The onset of secondary myelofibrosis made cytological monitoring of the bone marrow infiltrates impossible. As during progression of the disease splenectomy revealed typical histological features...

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Bibliographic Details
Published in:Human pathology 1998-07, Vol.29 (7), p.761-765
Main Authors: Weirich, G, Sandherr, M, Fellbaum, C, Richter, T, Schmidt, L, Kinjerski, T, Dietzfelbinger, H, Rastetter, J, Höfler, H
Format: Article
Language:English
Subjects:
Adult
Bone Marrow Neoplasms - complications
Bone Marrow Neoplasms - diagnosis
Bone Marrow Neoplasms - genetics
Decalcification Technique
DNA Primers - chemistry
DNA, Neoplasm - analysis
Formaldehyde
Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor - genetics
Humans
Immunoenzyme Techniques
Liver Neoplasms - complications
Liver Neoplasms - diagnosis
Liver Neoplasms - genetics
Lymphoma, T-Cell, Peripheral - complications
Lymphoma, T-Cell, Peripheral - diagnosis
Lymphoma, T-Cell, Peripheral - genetics
Male
Polymerase Chain Reaction - methods
Primary Myelofibrosis - etiology
Primary Myelofibrosis - pathology
Receptors, Antigen, T-Cell, gamma-delta - genetics
Splenic Neoplasms - complications
Splenic Neoplasms - diagnosis
Splenic Neoplasms - genetics
Tissue Fixation
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Summary:We describe the case of a middle-aged man with long indolent course of generalized Tgammadelta lymphoma. The onset of secondary myelofibrosis made cytological monitoring of the bone marrow infiltrates impossible. As during progression of the disease splenectomy revealed typical histological features of a high-grade hepatosplenic Tgammadelta lymphoma, the low-grade bone infiltrate was considered a secondary lymphoma. The use of the polymerase chain reaction helped to detect a constant and identical monoclonal rearrangement pattern of the T-cell receptor gamma-chain gene in both bone marrow and splenic T-cell infiltrates. The notion of a secondary spread of malignant T-cells to the bone marrow was thereby confirmed despite striking cytological differences between bone marrow and splenic infiltrates. This is the first report of a diagnostic DNA-based molecular approach using fixed decalcified bone marrow. This method may provide a major tool when dealing with myelofibrosis, which normally hampers sampling of cytological specimens.
ISSN:0046-8177