In situ determination of T-cell receptor beta expression patterns

A definitive diagnosis of T-cell lymphoma may be contingent on the rearrang ement profile of the T-cell receptor. This is most accurately done by molec ular analysis of the beta-chain of the T-cell receptor (TCR beta) by Southe rn blotting hybridization that requires unfixed tissue. We describe a rever se transcriptase in situ PCR (RT in situ PCR) method that permits the targe t-specific direct incorporation of the reporter nucleotide into the differe nt transcripts that comprise the TCR beta, using paraffin-embedded, formali n-fixed tissue. Each of the 25 possible V beta segment rearrangments was do cumented in three lymph nodes with nonspecific lymphadenitis with clonal ex pansion evident in a case of metastatic melanoma. Monoclonal expression was documented in seven tissues diagnostic of a T-cell lymphoma. We analyzed f ive additional tissues for which a definitive diagnosis of T-cell vs B-cell lymphoma could not be rendered on the basis of histological, immunohistolo gical, and flow cytometric analysis. RT in situ PCR for TCR beta expression with CD3 colabeling demonstrated which of these lesions was a B-cell-rich T-cell lymphoma. We conclude that the RT in situ PCR methodology will allow the routine determination of monoclonal vs multiclonal expression patterns of the TCR beta using archival paraffin-embedded tissues.