Confirmation of immunoglobulin heavy chain rearrangement by polymerase chain reaction using surgically obtained, paraffin-embedded samples to diagnose primary palate mucosa-associated lymphoid tissue lymphoma: A case study. (2015)

• Record Type: Journal Article
• Authors: Abe, Shigehiro; Yokomizo, Naoko; Kobayashi, Yutaka; Yamamoto, Kouhei
• Is Part Of: International journal of surgery case reports. Volume 10(2015)
• Page Start: 129
• Page End: 133
• Publication Date: 2015
• Subjects: Mucosa-associated lymphoid tissue lymphoma -- Oral cavity -- Polymerase chain reaction -- Immunoglobulin heavy chain gene rearrangement; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2015.03.046
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Intraoral mucosa-associated lymphoid tissue (MALT) lymphoma is a rare lymphoma. Distinguishing between MALT lymphoma from reactive lymphoproliferative disorders is a diagnostic dilemma. To obtain a definitive diagnosis, we used polymerase chain reaction, which confirmed the diagnosis of a MALT lymphoma. Abstract: Introduction: Intraoral mucosa-associated lymphoid tissue (MALT) lymphoma is a rare lymphoma that has a good prognosis if diagnosed correctly and treated in time. Presentation of case: A 64-year-old woman was referred to our department with asymptomatic swelling of the left hard palate. Computed tomography and magnetic resonance imaging revealed a mass in the left hard palate. We performed a pre-surgery biopsy; however, it was difficult to differentiate MALT lymphoma from other reactive lymphoproliferative disorders via gross or microscopic examination. Although the lesion was completely excised, histological findings did not allow a definitive diagnosis due to an absence of visible monoclonality. We then performed polymerase chain reaction (PCR) using DNA extracted from formalin-fixed, paraffin-embedded surgical samples. Capillary electrophoresis showed monoclonal peaks of immunoglobulin heavy chain gene rearrangement, thus facilitating a definitive diagnosis of MALT lymphoma. Discussion: PCR technique is rapid, accurate, and enables a definitive diagnosis without relying on traditional histological or molecular diagnostic techniques, such as Southern blotting. Conclusion: We suggest that, if histological examination is ambiguous or fresh material is insufficient, PCR can be performed using paraffin-embedded materials to definitively diagnose low-grade lymphomas, such as MALT lymphoma.