Patho-epidemiological studies have shown that thyroid lymphoma (TL) develop
s in thyroid affected by chronic lymphocytic thyroiditis (CLTH). CLTH is ca
tegorized as an organ-specific autoimmune disease, in which activated B-lym
phocytes secrete a number of autoantibodies. Because antigenic stimulation
might be involved in the pathogenesis of TL, the variable region in heavy c
hain (V-H) genes was characterized in 13 cases with TL and 3 with CLTH. Clo
nal rearrangement of the V-H gene was found in 11 cases of TL, and cloning
study with sequencing of complimentary determining region (CDR) 3 revealed
the presence of a major clone in 4. Three of the 4 cases used V(H)3 gene, w
ith the homologous germline gene of V3-30 in two cases and VH26 in one case
. A biased usage of V(H)3 and V(H)4 genes with the homologous germline gene
of VH26 in V(H)3 gene was reported previously in cases with CLTH. A high l
evel of somatic mutation (1-21%, average 12%) with non-random distribution
of replacement and silent mutations was accumulated in all cases. The frequ
ency of the occurrence of minor clones ranged from 29-44% per case, indicat
ing the presence of on-going mutation. DNA sequencing of immunoglobulin V-H
gene suggests that TL develops among activated lymphoid cells in CLTH at t
he germinal center stage under antigen selection.