Rearrangement of immunoglobulin gene in metastatic Waldenstrom macroglobulinemia to the vitreous

PURPOSE: To report metastatic Waldenstrom macroglobulinemia cells with immu noglobulin heavy chain gene rearrangement in the vitreous and the blood. METHODS: A 58-year-old man with Waldenstrom macroglobulinemia developed bil ateral vitreous, Diagnostic vitrectomy was performed on the left eye. The v itreous cells and the peripheral blood lymphocytes were analyzed using micr odissection and polymerase chain reaction amplification. RESULTS: Vitrectomy specimen of the left eye contained a few degenerated ce lls. Molecular analysis showed immunoglobulin heavy chain gene rearrangemen t at the third complementary determining region of the vitreal infiltrating cells and peripheral blood lymphocytes. CONCLUSIONS: Waldenstrom macroglobulinemia rarely metastasizes to the vitre ous. Molecular detection of the immunoglobulin heavy chain gene third compl ementary determining region rearrangement is helpful in the diagnosis of th e malignancy. Microdissection combined with polymerase chain reaction is a useful and innovative tool for molecular pathological investigation. (C) 20 00 by Elsevier Science Inc. All rights reserved.