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Use of Novel t(11;14) and t(14;18) Dual-Fusion Fluorescence In Situ Hybridization Probes in the Differential Diagnosis of Lymphomas of Small Lymphocytes

Frater, John L. M.D.; Tsiftsakis, Evangelos K. M.D.; Hsi, Eric D. M.D.; Pettay, James M.T. (ASCP); Tubbs, Raymond R. D.O.

Diagnostic Molecular Pathology: December 2001 - Volume 10 - Issue 4 - pp 214-222
Original Articles
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Increasingly, molecular biologic techniques have become important in the diagnosis of non-Hodgkin lymphomas. In the differential diagnosis of lymphoma(s) of small lymphocytes (LSL), reliable detection of t(11;14) or t(14;18) would confirm the diagnosis of mantle cell lymphoma (MCL) or follicle center lymphoma (FCL), respectively. A total of 87 LSL cases (27 MCL, 39 FCL, 17 small lymphocytic lymphoma [SLL], 3 marginal zone lymphomas, and 1 paraimmunoblastic variant of SLL) were diagnosed by a combination of light microscopy, immunohistochemistry, and flow cytometric immunophenotyping. Interphase fluorescence in situ hybridization (FISH) for t(11;14) and t(14;18) using dual-fusion probes (Vysis, Downers Grove, IL) was performed on touch (n = 69) or gravity (n = 18) preparations from these cases. Of 27 MCL cases tested, 25 (93%) had demonstrable t(11;14), none had t(14;18), and 2 were negative for t(11;14) and t(14;18). Twenty-five of 39 (64%) FCL cases had t(14;18), none had t(11;14), and the remaining FCL cases (14 cases [35%]) had neither t(11;14) nor t(14;18). All 17 (100%) SLL cases had neither t(11;14) nor t(14;18). All 3 (100%) marginal zone lymphoma cases had neither t(11;14) nor t(14;18). The case of paraimmunoblastic variant of SLL had t(11;14) and was negative for t(14;18). No discrepant [i.e., positive for both t(11;14) and t(14;18)] or false-positive cases were noted. Interphase FISH using these commercially available probes is a useful adjunct to light microscopy, immunohistochemistry, and flow cytometric immunophenotyping in the diagnosis of LSL. FISH can be performed successfully on archival single-cell preparations (touch preparations or gravity preparations) when fresh tissue is unavailable. No discordant or false-positive cases were identified.

From the Department of Clinical Pathology, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A.

Address correspondence and reprint requests to Raymond R. Tubbs, Department of Clinical Pathology, Cleveland Clinic Foundation, 9500 Euclid Avenue (L25), Cleveland, OH 44195; email: tubbsr@ccf.org.

Presented at the 90th Annual Meeting of the United States and Canadian Academy of Pathology, Atlanta, Georgia, March 5, 2001, and awarded the Certificate of Merit, Stowell-Orbison competition (Mod Pathol 2001;14:163A).

© 2001 Lippincott Williams & Wilkins, Inc.