Clonality analysis of alveolar B lymphocytes contributes to the diagnostic strategy in clinical suspicion of pulmonary lymphoma
| Autor: | Jean-Pierre Farcet, Bernard Epardeau, François Santoli, Simona Zompi, Natalia Popa, Jocelyne Fleury-Feith, Marie-Hélène Delfau-Larue, Louis-Jean Couderc, Martine Antoine, Jacques Cadranel |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Pathology
medicine.medical_specialty Lung Neoplasms Immunology Clone (cell biology) Primary pulmonary lymphoma Polymerase Chain Reaction Sensitivity and Specificity Biochemistry Predictive Value of Tests hemic and lymphatic diseases Biopsy medicine Humans Respiratory system B-Lymphocytes Lung Base Sequence medicine.diagnostic_test business.industry Lymphoma Non-Hodgkin Retrospective cohort study DNA Neoplasm Cell Biology Hematology medicine.disease Complementarity Determining Regions Clone Cells Lymphoma Pulmonary Alveoli medicine.anatomical_structure Bronchoalveolar lavage business Bronchoalveolar Lavage Fluid |
| Zdroj: | Blood. 103:3208-3215 |
| ISSN: | 1528-0020 0006-4971 |
| DOI: | 10.1182/blood-2003-07-2335 |
| Popis: | The diagnostic procedure of chronic pulmonary opacities may envisage the search for non-Hodgkin lymphoma (NHL). Previous retrospective studies have shown that clonality analysis of bronchoalveolar B lymphocytes could reflect the clonality of pulmonary lymphocytes. Our objective was to define the diagnostic usefulness of bronchoalveolar lavage (BAL) B-lymphocyte clonality analysis in the setting of a clinical suspicion of both primary and secondary pulmonary lymphoma. A prospective BAL fluid B-cell clonality analysis was performed by polymerase chain reaction (PCR) in 106 consecutive patients presenting with a clinical suspicion of pulmonary NHL. Diagnosis was pulmonary B-cell lymphoma for 22 patients (13 primary and 9 secondary). When compared, pulmonary biopsy and BAL fluid have clonal identity. The detection of a strong B-cell clonal population in BAL fluid was associated with the diagnosis of pulmonary NHL (P < .0001), with a 97% specificity and a 95% negative predictive value. Thus, the absence of a dominant B-cell clone detection in BAL fluid could help to dismiss invasive investigations of pulmonary lesions. The detection of a dominant B-cell clone would lead to the performance of a pulmonary biopsy to get histologic diagnosis in primary pulmonary lymphoma and, by contrast, would avoid the need for biopsy in the setting of a secondary pulmonary lymphoma. (Blood. 2004;103: 3208-3215) |
| Databáze: | OpenAIRE |
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