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[Malignant lymphoma displaying rearrangements of both immunoglobulin and T-cell receptor genes]
Insights
This study details a patient with recurrent malignant lymphoma, showing leukemic transformation and gastrointestinal infiltration. Gene analysis revealed T-cell receptor gene rearrangement without mRNA expression, indicating an ineffective process.
Area of Science:
- Oncology
- Hematology
- Molecular Biology
Background:
- Malignant lymphoma can present with extranodal involvement, including the gastrointestinal tract.
- Leukemic transformation of lymphoma signifies advanced disease and altered cellular behavior.
Observation:
- A 65-year-old male presented with recurrent malignant lymphoma of tonsil origin.
- Flow cytometry identified intermediate B cells in peripheral blood.
- Gastrointestinal endoscopy revealed diffuse infiltration of lymphoid cells in the stomach and colon.
Findings:
- Southern blot analysis showed both T-cell receptor beta-chain gene rearrangement and immunoglobulin gene rearrangement.
- In situ hybridization and Northern blot analysis demonstrated immunoglobulin mRNA expression but no T-cell receptor beta-chain mRNA in tumor cells.
- These findings suggest ineffective T-cell receptor gene rearrangement without transcription.
Implications:
- This case highlights the complex molecular events in lymphoma progression.
- Understanding ineffective gene rearrangement is crucial for accurate diagnosis and prognosis.
- Further research into the mechanisms of ineffective gene rearrangement in lymphoma is warranted.
Abstract:
A 65-year-old male was admitted to our hospital due to recurred malignant lymphoma of left tonsil origin. Studies using flow cytometry on mononuclear cells in peripheral blood revealed the appearance of intermediate B cells, and examinations on gastrointestinal tract showed diffuse infiltration of medium-sized lymphoid cells into stomach and colon, that had the same phenotype as tumor cells in peripheral blood. They suggested leukemic change and gastrointestinal tract infiltration of malignant lymphoma. Southern blot analysis revealed T-cell receptor beta-chain gene rearrangement as well as immunoglobulin gene rearrangement. Analysis by histo in situ hybridization on infiltrated gastric mucosa specimen showed diffuse expression of immunoglobulin mRNA in tumor cells, but no message of T-cell receptor beta-chain gene. Northern blot analysis showed the same result. It suggests that in this case, the rearrangement of T-cell receptor beta-chain gene is ineffective rearrangement without transcription to mRNA.