K. Ohshima et al., GENETIC CHANGES IN ATYPICAL HYPERPLASIA AND LYMPHOMA WITH ANGIOIMMUNOBLASTIC LYMPHADENOPATHY AND DYSPROTEINEMIA IN THE SAME PATIENTS, Virchows Archiv, 425(1), 1994, pp. 25-32
The transition between atypical hyperplasia and lymphoma with angioimm
unoblastic lymphadenopathy and dysproteinaemia (AILD) was studied in s
erial lymp node biopsy specimens from five patients using DNA analysis
with Southern blot analysis, polymerase chain reaction, chromosomal a
nalysis, and immunophenotyping. The chromosomal analysis showed additi
onal abnormalities as the disease progressed to those present initiall
y, and immunological staining showed a corresponding increase in the n
umbers of CD4- and Ki67-positive cells. In the first biopsy from each
patient a diagnosis of atypical hyperplasia with AILD was made and lym
phoma excluding by the finding of only a few atypical lymphoid cells a
nd the preservation of follicles with germinal centres. DNA analysis o
f lymph nodes at this stage showed either germ lines or oligoclonal re
arrangements of the T-cell receptor (TCR) and immunoglobulin heavy cha
in genes. In the final biopsy, when a diagnosis of lymphoma with AILD
was made, either a monoclonal rearrangement of the TCR was observed or
one of the rearranged bands had increased in density. These results s
uggest selective proliferation of a clone of abnormal cells may accoun
t for the progression of atypical hyperplasia to lymphoma with AILD.