Clonal Analysis of Multiple Lymphoproliferative Lesions (LPDs) in HIV Positive Patients
Jacqueline Lekostaj, Juehua Gao, David Dittman, Amy Chadburn. Northwestern University Feinberg School of Medicine, Chicago, IL
Background: Malignant lymphoma is generally thought to be a monoclonal process involving one or more sites in a patient (pt). In the setting of immunosuppression and Epstein Barr virus (EBV) infection clonally distinct LPDs may arise in a single individual; furthermore morphology does not always correlate with clonality. HIV+ pts are immunosuppressed and often infected with EBV. However, whether multiple LPDs, reactive and/or neoplastic, occurring in an individual HIV+ pt are of identical or disparate clonal content, or are clonally consistent with morphology has not been fully investigated.
Design: DNA from touch preparations or FFPE tissue of 2-4 LPDs from 10 HIV+ pts (M:9/F:1; age 28-53 yrs) was amplified using primer sets for heavy (H), kappa (K) and lambda (L) immunoglobulin loci. Samples were assessed for quality using a control gene primer set. PCR products were analyzed by capillary electrophoresis. Monoclonal was defined as a peak >3 times the height of the third highest peak in the appropriate region. EBV was detected by in situ hybridization with an EBER probe. Tests performed were dependent on available material.
|Pt. 1@||Pt. 2^||Pt. 3**||Pt. 4||Pt. 5||Pt. 6||Pt. 7|
|Lesion 2 - Time||DLBCL-14mo||DLBCL-18mo||DLBCL-1wk||DLBCL-2 wk||BL-1wk||Rxt-2mo||Rxt-2wk|
|EBV (#1; #2)||Pos;Pos||Pos;Pos||NA;NA||Pos;Pos||NA||NA;Rare||Pos;NA|