DETECTION OF LYMPHOMATOUS INVOLVEMENT OF THE LUNG BY BRONCHOALVEOLAR LAVAGE - APPLICATION OF IMMUNOPHENOTYPIC AND GENE REARRANGEMENT ANALYSIS

We report three cases of pulmonary involvement of non-Hodgkin's lympho ma in which immunophenotypic or gene rearrangement analysis of broncho alveolar lavage (BAL) cells demonstrated monoclonality of T- or B-cell lineage. The first patient had T-cell lymphoma and developed pulmonar y lesions. Surface marker analysis of the BAL cells revealed that CD8- positive lymphoid cells were dominant and Southern blot analysis of T- cell receptor gene detected gene rearrangement demonstrating monoclona lity of T-cell lineage. The second patient presented with diffuse micr onodular shadows on chest radiograph. Marked B-lymphocytosis in BAL fl uid prompted us to analyze their clonality. The third was a case in wh ich recurrence of primary pulmonary lymphoma was suspected. In the sec ond and third case, the finding of marked increase in the number of CD 19-positive B lymphocytes with a single class of light chains proved a monoclonal population in BAL Cells. With the review of other cases in our study and the relevant literature, we conclude that the clonal an alysis of BAL cells is helpful in establishing the diagnosis of pulmon ary involvement of T- or B-cell lymphoma.