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Detection of kappa- and lambda-expressing cells in the endometrium by in situ hybridization
Elizabeth Euscher1, Gerard J Nuovo
1Department of Pathology, Ohio State University Medical Center, Columbus 43210, USA.
Insights
In situ hybridization detects kappa and lambda light chains in endometrial biopsies, aiding chronic endometritis diagnosis. This method is useful when plasma cell identification is difficult.
Area of Science:
- Gynecologic Pathology
- Immunohistochemistry
- Molecular Diagnostics
Background:
- Kappa and lambda light chain expression is crucial for B-lymphocyte and plasma cell identification.
- Endometrial biopsy analysis often relies on histologic interpretation of plasma cell infiltration.
- Distinguishing between normal plasma cell levels and those indicative of pathology can be challenging.
Purpose of the Study:
- To correlate in situ hybridization detection of kappa and lambda light chains with histologic findings in endometrial biopsies.
- To evaluate the utility of in situ hybridization for light chain expression in diagnosing chronic endometritis.
- To assess the prevalence of kappa and lambda expressing cells in various endometrial conditions.
Main Methods:
- Analysis of 40 endometrial biopsies using in situ hybridization for kappa and lambda light chain expression.
- Quantification of positive cells per 10x100 fields in serial sections.
- Correlation of light chain expression data with histologic findings, including endometrial glands, fibrosis, and plasma cell counts.
Main Results:
- Kappa and lambda expressing cells were detected in 98% of biopsies.
- Significantly higher numbers of expressing cells were observed in endometritis (623 cells) and adenocarcinoma (677 cells) compared to proliferative (13 cells) and secretory (16 cells) endometrium.
- Many B lymphocytes expressed light chains without typical plasma cell morphology.
- Normal cycling endometrium showed common expression, suggesting mild chronic antigenic stimulation.
Conclusions:
- In situ hybridization for kappa and lambda light chain expression is a valuable adjunct in diagnosing chronic endometritis, especially when plasma cell assessment is equivocal.
- The presence of kappa and lambda expressing cells is common in normal endometrium, indicating a baseline level of immune activity.
- This technique can help differentiate pathological conditions from normal findings when plasma cells are scarce.
Abstract:
The detection of kappa- and lambda-expressing cells in endometrial biopsies using in situ hybridization was correlated with the histologic findings. Forty endometrial biopsies were examined in conjunction with kappa and lambda expression in serial sections, recorded as the number of positive cells per 10 x100 fields. Cells expressing kappa or lambda were found in 39/40 (98%) biopsies with the average total number per 10 x100 fields as follows: proliferative (n = 13) 13; secretory (n = 6) 16; endometritis (n = 6) 623; polyp (n = 4) 72; adenocarcinoma (n = 6) 677; oral contraceptive effect (n = 5) 8. Many of the B lymphocytes expressing kappa and lambda did not have the cytologic features of plasma cells. The diagnosis of chronic endometritis can be made when the histologic findings of out-of-phase endometrial glands and focal fibrosis are seen with increased plasma cells; in cases where the latter is equivocal, in situ hybridization testing for light chain expression can be useful. Cells expressing kappa and lambda mRNA are relatively common in normally cycling endometrium, implying that mild chronic antigenic stimulation is present in most endometrial tissues. In situ hybridization for light chain expression can be helpful in endometria where only very rare plasma cells are seen; a baseline result would rule out chronic endometritis.
