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Published on: July 20, 2016
Molecular methods to distinguish reactive and neoplastic lymphocyte expansions and their importance in transitional
1Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, CO 80523, USA.
Insights
Diagnosing lymphoma and leukemia can be challenging. Molecular diagnostic tools like gene expression profiling help distinguish reactive from neoplastic lymphocytes, aiding early detection and treatment.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Lymphoma and leukemia diagnosis can be challenging, particularly differentiating reactive from neoplastic lymphocytes.
- Routine cytology and histology may not always suffice for definitive diagnosis.
Purpose of the Study:
- To review current and emerging molecular diagnostic methods for analyzing lymphocyte populations.
- To discuss the application of these methods in clarifying diagnostic dilemmas in hematologic malignancies.
- To explore the concept of transitional neoplastic states and their diagnostic implications.
Main Methods:
- Immunophenotyping to analyze lymphocyte surface markers.
- Clonality assessment of immunoglobulin and T-cell receptor genes.
- Detection of chromosomal abnormalities.
- Gene expression profiling for oncogene identification.
Main Results:
- Immunophenotyping and gene rearrangement studies are valuable for distinguishing reactive from neoplastic lymphocytes.
- Chromosomal abnormalities can aid in diagnosis.
- Gene expression profiling offers future potential for identifying oncogenes.
- Transitional neoplastic states, linked to stimuli like Helicobacter pylori infection, highlight the need for advanced diagnostics.
Conclusions:
- A comprehensive array of molecular diagnostic tools is essential for accurate characterization of lymphocyte populations.
- Improved diagnostic capabilities enhance early detection of neoplastic lymphocytes.
- Targeting infectious or inflammatory stimuli may lead to cures in cases of transitional neoplastic states.
Abstract:
Although lymphoma and leukemia usually can be diagnosed by routine cytology and histology, some cases present a diagnostic challenge for pathologists and clinicians. Often the dilemma lies in determining whether a population of lymphocytes is reactive or neoplastic. We review currently available methods for analyzing lymphocyte populations by immunophenotyping and by identifying clonally rearranged immunoglobulin and T-cell receptor genes and discuss how these tests can be used to clarify such diagnostic dilemmas. We also describe the detection of chromosomal abnormalities and methods on the horizon, such as gene expression profiling, to identify diagnostically useful oncogenes. Finally, we review the emerging concept of transitional neoplastic states, in which reactive lymphocytes transform to neoplastic lymphocytes in the presence of continued antigenic stimulation, such as that caused by infection with Helicobacter pylori. The existence of transitional neoplastic states underscores the need for an array of molecular diagnostic tools that would improve our ability to characterize lymphocyte populations in human and animal patients and enhance early detection of neoplastic lymphocytes such that eradication of the infectious or inflammatory stimulus could lead to cure.
