Detection of immunoglobulin light‐chain restriction in cutaneous B‐cell lymphomas by ultrasensitive bright‐field mRNA in situ hybridization. (15th December 2014)

• Record Type: Journal Article
• Authors: Minca, Eugen C; Wang, Hongwei; Wang, Zhen; Lanigan, Christopher; Billings, Steven D; Luo, Yuling; Tubbs, Raymond R; Ma, Xiao‐Jun
• Is Part Of: Journal of cutaneous pathology. Volume 42:Number 2(2015:Feb.)
• Page Start: 82
• Page End: 89
• Publication Date: 2014-12-15
• Subjects: Skin -- Diseases -- Periodicals; Dermatology -- Periodicals; 616
• DOI: 10.1111/cup.12415
• Languages: English
• ISSNs: 0303-6987

Abstract

<abstract abstract-type="main" id="cup12415-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cup12415-sec-0001" sec-type="section"> <title>Background</title> <p id="cup12415-para-0001">Detection of immunoglobulin light‐chain restriction is important in the diagnosis of B‐cell non‐Hodgkin lymphoma (B‐NHL). Flow‐cytometry, commonly used to evaluate light‐chain restriction, is impractical to be used in cutaneous specimens. Immunohistochemical and conventional chromogenic <italic>in situ</italic> hybridization (CISH) methods on formalin‐fixed‐paraffin‐embedded (FFPE) tissue lack sufficient sensitivity to detect low‐level light‐chain expression in B‐NHL without plasmacytic differentiation. Ultrasensitive bright‐field mRNA‐ISH (BRISH) for <italic>in situ</italic> light‐chain detection in cutaneous B‐NHL has been assessed.</p> </sec> <sec id="cup12415-sec-0002" sec-type="section"> <title>Design</title> <p id="cup12415-para-0002">Kappa/lambda mRNA was detected using two‐color BRISH (RNAscope 2xPlex, Advanced Cell Diagnostics) on 27 FFPE skin biopsies and excisions from patients with available B‐cell PCR clonality studies: 16 clonal B‐cell lesions (6 follicle center lymphoma, 5 marginal zone lymphoma, 3 large B‐cell lymphoma, and 2 other) and 11 non‐clonal B‐cell proliferations.</p> </sec> <sec id="cup12415-sec-0003" sec-type="section"> <title>Results</title> <p id="cup12415-para-0003">BRISH was successful in 15/16 clonal B‐cell lesions and 11/11 non‐clonal proliferations. Light‐chain restriction was detected in 15/15 clonal lesions and in 1/11 non‐clonal proliferations (96.1% overall concordance with clonality PCR). In 4/5 marginal zone lymphomas, light‐chain restriction was detected as strong monotypic mRNA expression in a B‐cell subset, consistent with plasmacytic differentiation.</p> </sec> <sec id="cup12415-sec-0004" sec-type="section"> <title>Conclusion</title> <p id="cup12415-para-0004">Ultrasensitive BRISH can successfully detect light‐chain restriction in B‐NHL from FFPE skin specimens and may be a useful adjunct ancillary tool in cases not resolved by CISH or immunohistochemical methods.</p> </sec> </abstract>