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Detection of immunoglobulin light‐chain restriction in cutaneous B‐cell lymphomas by ultrasensitive bright‐field mRNA in situ hybridization
Author(s) -
Minca Eugen C,
Wang Hongwei,
Wang Zhen,
Lanigan Christopher,
Billings Steven D,
Luo Yuling,
Tubbs Raymond R,
Ma XiaoJun
Publication year - 2015
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.12415
Subject(s) - immunoglobulin light chain , chromogenic in situ hybridization , lymphoma , biology , cish , pathology , in situ hybridization , b cell , immunohistochemistry , microbiology and biotechnology , antibody , medicine , immunology , messenger rna , gene , genetics
Background 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 in situ 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 in situ light‐chain detection in cutaneous B‐ NHL has been assessed. Design 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. Results 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. Conclusion 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.