Abstract
BACKGROUND: The novel technology of tissue microarray (TMA) allows rapid and cost-effective analysis of hundreds of markers on the same set of specimens. Limited amount of tissue that could be analyzed and problem of tissue heterogeneity, are the major drawbacks of TMA technique for immunohistochemical characterization of lymphomas. METHODS: In this paper 65 cases of lymphomas were analyzed using TMA with following panel of antibodies: BOB1, Oct2, Bcl2, Bcl6, CD20, CD21, CD23, CD3, CD5, CD10, CD43, CD79a, CD138, Cyclin D1, Ki67, MUM1, Pax5, p53. RESULTS: In 14 patients with diffuse large B-cell lymphoma (DLBCL), 5 were classified as germinative center and 3 as non-germinative center cases according to the Bcl6, CD10, and MUM1 positivity. Other 2 patients were identified as T cell rich B cell lymphoma based on morphology and Oct2 and BOB1 positivity of pleomorphic B lymphocytes. DLBCL with Bcl6+ immunophenotype had better overall survival than Bcl6- cases. All cases of classic mantle cell lymphoma had significantly lower Ki-67 proliferation index than blastoid subtypes. There were 14 cases of chronic lymphocytic leukemia/small cell lymphocytic lymphoma, 6 cases with follicular lymphoma, 5 cases of marginal zone lymphoma, and 7 cases of lymphoplazmacitoid lymphoma. In the indolent lymphoma group, survival of patients with p53+/- was poorer comparing to p53- group. CONCLUSION: We conclude that TMA technique is a valuable method in diagnosis and prognosis of lymphomas, which are considered very heterogeneous group of hematological neoplasms.
Highlights
The novel technology of tissue microarray (TMA) preparation for high throughput profiling of tumor specimens was originally described in 1998 by Kononen et al [1]
Certain molecular markers in lymphoma correlate with differences in course of disease, e.g., p53 over-expression predicts a worse outcome in patients with B-cell chronic lymphocytic leukemia (B-CLL), certain low-grade lymphomas, and mantle cell lymphoma (MCL) irrespective of the stage of disease [2]
In lymphomas was found that added redundancy of 3 cores/case reduced the numbers of cases placed on TMA, but it did not increased the accuracy of a particular stain if tumor cells were present [9]
Summary
The novel technology of tissue microarray (TMA) preparation for high throughput profiling of tumor specimens was originally described in 1998 by Kononen et al [1]. E.g. in Hodgkin's lymphoma or T-cell-rich B-cell lymphoma, are outnumbered by non-neoplastic background infiltrates and may only be present in very low numbers in TMA punch biopsies. Lymphoma growth may follow lymphoid structures (such as follicles in FL or mantle zone infiltration in MCL), TMA punch biopsies, in contrast to many solid tumors, may not contain relevant tumor areas.
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