Detection of concurrent/recurrent non-Hodgkin's lymphoma in effusions by PCR

A subset of patients with non-Hodgkin's lymphoma (NHL), present with or sub sequently develop lymphonytic effusions. Differential diagnosis between rea ctive lymphocytosis and recurrent low-grade NHL is difficult by cytology al one. We studied the use of polymerase chain reaction (PCR)-based techniques to detect concurrent/recurrent NHL. Both primary tumors and atypical lymph ocytic effusions of 12 low-grade B-NHL patients and 4 T-NHL patients were s tudied. Six pleural effusions (reactive/carcinomatous), in patients; with n o history of NHL, were included. Samples were amplified by PCR, using Fr3, Fr2, LJH, and VLJH primers specific for the immunoglobulin heavy chain (IgH ) gene and V gamma-8, V gamma 9, V gamma 10, V gamma 11 and J gamma 1/J gam ma 2 consensus primers specific for the T-cell receptor gamma (TCR-gamma) g ene. IgH gene PCR products were analyzed by polyacrylamide gel electrophore sis (PAGE). TCR-gamma gene PCR products were analyzed using a novel nonradi oactive single-strand conformational polymorphism (SSCP) procedure. IgH gen e rearrangement analysis demonstrated monoclonality in 11/12 primary low-gr ade B-NHLs. Identical monoclonal bands were found in both primary tumor and effusion in 9 patients. TCR-gamma gene rearrangement analysis demonstrated monoclonality in 4 of 4 primary T-NHLs. Identical monoclonal banded patter ns were found in both primary tumor and effusion in 3 patients. Our results strongly support the diagnosis of concurrent/recurrent NHL in 13 of 16 (81 %) cases of atypical lymphocytic effusions. IgH/PAGE and TCR-gamma/SSCP ana lyses are useful tools in the diagnoses of lymphocytic effusions in patient s with NHL. Copyright (C) 1999 by W.B. Saunders Company.