Distinct B-cell clonal bands inHelicobacter pylori gastritis with lymphoid hyperplasia
✍ Scribed by Saxena, Anurag; Moshynska, Oksana; Kanthan, Rani; Bhutani, Mohit; Maksymiuk, Andrew W.; Lukie, Bryan E.
- Book ID
- 101221573
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 294 KB
- Volume
- 190
- Category
- Article
- ISSN
- 0022-3417
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✦ Synopsis
Helicobacter pylori (Hp)-associated gastritis is a risk factor for gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Clonal B-cell populations are present in both reactive and neoplastic MALT tissue, thus limiting their usefulness in the evaluation of gastric lymphoid in®ltrates in endoscopic biopsy specimens. The aim of this study was to identify the presence of clonal B-cell populations in Hp-gastritis with MALT and to assess their usefulness in distinguishing reactive from malignant in®ltrates. Routinely ®xed paraf®n-embedded blocks from 20 patients with Hp-gastritis with lymphoid hyperplasia were analysed for B-cell clonality by a semi-nested polymerase chain reaction (PCR) using FRIII/LJH and FRIII/VLJH primers for ampli®cation of the VDJ region of the immunoglobulin heavy chain gene. The histopathological ®ndings were evaluated according to a previously published scoring system. Immunohistochemistry was performed by the labelled streptavidin±biotin technique using the following primary antibodies: CD45, CD45RO, CD3, CD20, and cytokeratin. The histopathological ®ndings were diagnostic of Hp-chronic active gastritis (grade 2, n=17; grade 3, n=3). Scattered intraepithelial B-cells were present in all cases and non-destructive lymphoepithelial lesions in one grade 3 case. Ampli®able DNA was obtained from all samples. Clonal bands were observed in ten (7/17 grade 2 and 3/3 grade 3 lesions) and polyclonal smears in ten cases (all grade 2). The clonal bands were often (n=6) associated with a background polyclonal smear and were not reproducible from deeper sections (n=10) or another paraf®n block (n=1), while the clonal bands in control lowgrade MALT lymphomas were not associated with a background smear and were reproducible from deeper sections. None of the patients has developed lymphoma to date (follow-up 21±44 months). In conclusion, B-cell clonal bands are common in H. pylori-gastritis with lymphoid hyperplasia. The irreproducibility of these bands is a useful feature in favouring a reactive process.