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Primary gastric lymphomas: morphologic, immunohistochemical and immunogenetic analyses
1First Department of Pathology, Nagoya University School of Medicine, Japan.
Pathology International
|September 1, 1996
Summary
This study analyzed 28 primary gastric lymphomas, differentiating subtypes and identifying Epstein-Barr virus in some cases. Findings suggest current diagnostic criteria for mucosa-associated lymphoid tissue (MALT) lymphoma may need revision.
Area of Science:
- Gastroenterology
- Hematology
- Oncology
Background:
- Primary gastric lymphomas are diverse, necessitating accurate classification for effective treatment.
- Immunohistochemical and immunogenetic analyses are crucial for subtyping gastric lymphomas.
- The diagnostic criteria for mucosa-associated lymphoid tissue (MALT) lymphoma require ongoing evaluation.
Purpose of the Study:
- To classify 28 primary gastric lymphoma cases using morphologic, immunohistochemical, and immunogenetic methods.
- To investigate the potential germinal center origin of diffuse large B-cell lymphoma.
- To assess the validity of current diagnostic criteria for MALT lymphoma and explore the role of Epstein-Barr virus.
Main Methods:
- Morphologic examination of fresh frozen gastric lymphoma tissues.
- Immunohistochemical analysis using various monoclonal antibodies.
- Immunogenetic studies including JH gene rearrangement analysis.
- In situ hybridization (ISH) and polymerase chain reaction (PCR) for Epstein-Barr virus detection.
Main Results:
- Classified 28 gastric lymphomas into subtypes including diffuse large B-cell lymphoma, follicular center lymphoma, MALT lymphoma, plasmacytoma, T-cell lymphoma, mantle cell lymphoma, lymphoplasmacytoid lymphoma, and Hodgkin's disease.
- Differentiated four types of morphologically similar low-grade lymphomas using immunohistochemistry.
- Observed lympho-epithelial lesions in non-MALT lymphomas, questioning current diagnostic criteria.
- Detected JH gene clonal rearrangement in 17 of 22 cases (excluding T-cell lymphoma and Hodgkin's disease).
- Identified Epstein-Barr virus genomes in 2 (ISH) and 3 (PCR) cases, suggesting a potential role in lymphomagenesis.
Conclusions:
- Immunohistochemistry aids in differentiating morphologically similar low-grade gastric lymphomas.
- Current diagnostic criteria for MALT lymphoma may not be universally applicable.
- Epstein-Barr virus is infrequently associated with gastric lymphomas but may contribute to lymphomagenesis.