Molecular pathology of primary intraocular lymphoma.
Abstract
PURPOSE: To evaluate immunoglobulin heavy chain (IgH) gene rearrangements, cytokines and chemokines, and infectious agents in primary intraocular B-cell lymphoma (PIOL) cells, in order to better diagnose and understand PIOL. METHODS: We studied ocular specimens from 57 patients with PIOL at the National Eye Institute from 1991 to 2001. Specimens were analyzed for IgH gene rearrangements using microdissection and polymerase chain reaction (PCR). We measured vitreal interleukin (IL)-10 and IL-6 levels by enzyme-linked immunosorbent assay. IL-10 mRNA was studied in PIOL cells using microdissection and reverse transcribed (RT)-PCR. Chemokine and chemokine receptor expression was examined by using immunohistochemistry. Infectious DNA of human herpetic virus-8 (HHV-8), Epstein-Bar virus (EBV), and Toxoplasma gondii was detected by using microdissection and PCR and was confirmed with Southern blot hybridization. RESULTS: IgH rearrangement(s) were demonstrated in all 50 tested cases. Cytokine levels were measured in the vitreous of 39 patients. Thirty-one had measurable cytokine levels: 24 of 31 had elevation of IL-10 relative to that of IL-6, and, in contrast, only 7 of 31 had elevation of IL-6 relative to IL-10. IL-10 mRNA was abundant in lymphoma cells of 6 examined cases. Lymphoma cells expressed chemokine receptors of CXCR4 and CXCR5 in three tested cases. HHV-8 DNA was found in 6 of 32 cases (18.8%), EBV DNA in 2 of 21 (9.5%), and T gondii DNA in 2 of 16 (12.5%). CONCLUSIONS: Molecular analyses detecting IgH rearrangements and vitreal levels of IL-10 and IL-6 are useful adjuncts for PIOL diagnosis. A role for specific infectious agents is hypothesized in the pathogenesis of some cases of PIOL. B-cell chemokine is likely involved in attracting PIOL cells into the eye.
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- Qualman SJ, Mendelsohn G, Mann RB, Green WR. Intraocular lymphomas. Natural history based on a clinicopathologic study of eight cases and review of the literature. Cancer. 1983 Sep 1;52(5):878–886. [PubMed] [Google Scholar]
- Buggage RR, Chan CC, Nussenblatt RB. Ocular manifestations of central nervous system lymphoma. Curr Opin Oncol. 2001 May;13(3):137–142. [PubMed] [Google Scholar]
- Whitcup SM, de Smet MD, Rubin BI, Palestine AG, Martin DF, Burnier M, Jr, Chan CC, Nussenblatt RB. Intraocular lymphoma. Clinical and histopathologic diagnosis. Ophthalmology. 1993 Sep;100(9):1399–1406. [PubMed] [Google Scholar]
- Bataille B, Delwail V, Menet E, Vandermarcq P, Ingrand P, Wager M, Guy G, Lapierre F. Primary intracerebral malignant lymphoma: report of 248 cases. J Neurosurg. 2000 Feb;92(2):261–266. [PubMed] [Google Scholar]
- Paulus W. Classification, pathogenesis and molecular pathology of primary CNS lymphomas. J Neurooncol. 1999 Jul;43(3):203–208. [PubMed] [Google Scholar]
- Nelson CC, Hertzberg BS, Klintworth GK. A histopathologic study of 716 unselected eyes in patients with cancer at the time of death. Am J Ophthalmol. 1983 Jun;95(6):788–793. [PubMed] [Google Scholar]
- Rattray KM, Cole MD, Smith SR. Systemic non-Hodgkin's lymphoma presenting as a serpiginous choroidopathy: report of a case and review of the literature. Eye (Lond) 2000 Oct;14(Pt 5):706–710. [PubMed] [Google Scholar]
- COOPER EL, RIKER JL. Malignant lymphoma of the uveal tract. Am J Ophthalmol. 1951 Aug;34(8):1153–1158. [PubMed] [Google Scholar]
- Vogel MH, Font RL, Zimmerman LE, Levine RA. Reticulum cell sarcoma of the retina and uvea. Report of six cases and review of the literature. Am J Ophthalmol. 1968 Aug;66(2):205–215. [PubMed] [Google Scholar]
- Kaplan HJ, Meredith TA, Aaberg TM, Keller RH. Reclassification of intraocular reticulum cell sarcoma (histiocytic lymphoma). Immunologic characterization of vitreous cells. Arch Ophthalmol. 1980 Apr;98(4):707–710. [PubMed] [Google Scholar]
- Schabet M. Epidemiology of primary CNS lymphoma. J Neurooncol. 1999 Jul;43(3):199–201. [PubMed] [Google Scholar]
- Eby NL, Grufferman S, Flannelly CM, Schold SC, Jr, Vogel FS, Burger PC. Increasing incidence of primary brain lymphoma in the US. Cancer. 1988 Dec 1;62(11):2461–2465. [PubMed] [Google Scholar]
- Thomas JO. Acquired immunodeficiency syndrome-associated cancers in Sub-Saharan Africa. Semin Oncol. 2001 Apr;28(2):198–206. [PubMed] [Google Scholar]
- Nasir S, DeAngelis LM. Update on the management of primary CNS lymphoma. Oncology (Williston Park) 2000 Feb;14(2):228–244. [PubMed] [Google Scholar]
- DeAngelis LM. Brain tumors. N Engl J Med. 2001 Jan 11;344(2):114–123. [PubMed] [Google Scholar]
- Corn BW, Marcus SM, Topham A, Hauck W, Curran WJ., Jr Will primary central nervous system lymphoma be the most frequent brain tumor diagnosed in the year 2000? Cancer. 1997 Jun 15;79(12):2409–2413. [PubMed] [Google Scholar]
- Peterson K, Gordon KB, Heinemann MH, DeAngelis LM. The clinical spectrum of ocular lymphoma. Cancer. 1993 Aug 1;72(3):843–849. [PubMed] [Google Scholar]
- Cassoux N, Merle-Beral H, Leblond V, Bodaghi B, Miléa D, Gerber S, Fardeau C, Reux I, Xuan KH, Chan CC, et al. Ocular and central nervous system lymphoma: clinical features and diagnosis. Ocul Immunol Inflamm. 2000 Dec;8(4):243–250. [PubMed] [Google Scholar]
- Akpek EK, Ahmed I, Hochberg FH, Soheilian M, Dryja TP, Jakobiec FA, Foster CS. Intraocular-central nervous system lymphoma: clinical features, diagnosis, and outcomes. Ophthalmology. 1999 Sep;106(9):1805–1810. [PubMed] [Google Scholar]
- Siegel MJ, Dalton J, Friedman AH, Strauchen J, Watson C. Ten-year experience with primary ocular 'reticulum cell sarcoma' (large cell non-Hodgkin's lymphoma). Br J Ophthalmol. 1989 May;73(5):342–346.[PMC free article] [PubMed] [Google Scholar]
- Ursea R, Heinemann MH, Silverman RH, Deangelis LM, Daly SW, Coleman DJ. Ophthalmic, ultrasonographic findings in primary central nervous system lymphoma with ocular involvement. Retina. 1997;17(2):118–123. [PubMed] [Google Scholar]
- Matsuo T, Yamaoka A, Shiraga F, Matsuo N. Two types of initial ocular manifestations in intraocular-central nervous system lymphoma. Retina. 1998;18(4):301–307. [PubMed] [Google Scholar]
- Velez G, de Smet MD, Whitcup SM, Robinson M, Nussenblatt RB, Chan CC. Iris involvement in primary intraocular lymphoma: report of two cases and review of the literature. Surv Ophthalmol. 2000 May-Jun;44(6):518–526. [PubMed] [Google Scholar]
- Rothova A, Ooijman F, Kerkhoff F, Van Der Lelij A, Lokhorst HM. Uveitis masquerade syndromes. Ophthalmology. 2001 Feb;108(2):386–399. [PubMed] [Google Scholar]
- Gill MK, Jampol LM. Variations in the presentation of primary intraocular lymphoma: case reports and a review. Surv Ophthalmol. 2001 May-Jun;45(6):463–471. [PubMed] [Google Scholar]
- Merchant A, Foster CS. Primary intraocular lymphoma. Int Ophthalmol Clin. 1997 Fall;37(4):101–115. [PubMed] [Google Scholar]
- Ridley ME, McDonald HR, Sternberg P, Jr, Blumenkranz MS, Zarbin MA, Schachat AP. Retinal manifestations of ocular lymphoma (reticulum cell sarcoma). Ophthalmology. 1992 Jul;99(7):1153–1161. [PubMed] [Google Scholar]
- Dean JM, Novak MA, Chan CC, Green WR. Tumor detachments of the retinal pigment epithelium in ocular/ central nervous system lymphoma. Retina. 1996;16(1):47–56. [PubMed] [Google Scholar]
- Herrlinger U. Primary CNS lymphoma: findings outside the brain. J Neurooncol. 1999 Jul;43(3):227–230. [PubMed] [Google Scholar]
- Davis JW, Moriarty RP, Schlossberg SM, Schellhammer PF. Bilateral testicular lymphoma treated with chemotherapy and radiation without orchiectomy: complete response relapsed at 52 months in the vitreous humor. Urology. 2001 Mar;57(3):555–555. [PubMed] [Google Scholar]
- Herrlinger U, Schabet M, Bitzer M, Petersen D, Krauseneck P. Primary central nervous system lymphoma: from clinical presentation to diagnosis. J Neurooncol. 1999 Jul;43(3):219–226. [PubMed] [Google Scholar]
- Ciricillo SF, Rosenblum ML. Use of CT and MR imaging to distinguish intracranial lesions and to define the need for biopsy in AIDS patients. J Neurosurg. 1990 Nov;73(5):720–724. [PubMed] [Google Scholar]
- Davis JL, Solomon D, Nussenblatt RB, Palestine AG, Chan CC. Immunocytochemical staining of vitreous cells. Indications, techniques, and results. Ophthalmology. 1992 Feb;99(2):250–256. [PubMed] [Google Scholar]
- Whitcup SM, Chan CC, Buggage RR, Nussenblatt RB, Byrnes GA, Rubin BI. Improving the diagnostic yield of vitrectomy for intraocular lymphoma. Arch Ophthalmol. 2000 Mar;118(3):446–446. [PubMed] [Google Scholar]
- Barr CC, Green WR, Payne JW, Knox DL, Jensen AD, Thompson RL. Intraocular reticulum-cell sarcoma: clinico-pathologic study of four cases and review of the literature. Surv Ophthalmol. 1975 Jan-Feb;19(4):224–239. [PubMed] [Google Scholar]
- Matsuo K, Nakatuka K, Matsuura T, Yokoyama S. Primary intraocular lymphoma mimicking late postoperative endophthalmitis. Ophthalmologica. 1995;209(6):331–335. [PubMed] [Google Scholar]
- Kirmani MH, Thomas EL, Rao NA, Laborde RP. Intraocular reticulum cell sarcoma: diagnosis by choroidal biopsy. Br J Ophthalmol. 1987 Oct;71(10):748–752.[PMC free article] [PubMed] [Google Scholar]
- Lopez JS, Chan CC, Burnier M, Rubin B, Nussenblatt RB. Immunohistochemistry findings in primary intraocular lymphoma. Am J Ophthalmol. 1991 Oct 15;112(4):472–474. [PubMed] [Google Scholar]
- Lefebvre A, Candaele C, Verbraeken H, Praet M, Hanssens M, De Laey JJ. Choroidal biopsy in the diagnosis of a suspect intraocular lesions. Bull Soc Belge Ophtalmol. 1995;255:93–97. [PubMed] [Google Scholar]
- Buggage RR, Velez G, Myers-Powell B, Shen D, Whitcup SM, Chan CC. Primary intraocular lymphoma with a low interleukin 10 to interleukin 6 ratio and heterogeneous IgH gene rearrangement. Arch Ophthalmol. 1999 Sep;117(9):1239–1242. [PubMed] [Google Scholar]
- Shields JA, Shields CL, Ehya H, Eagle RC, Jr, De Potter P. Fine-needle aspiration biopsy of suspected intraocular tumors. The 1992 Urwick Lecture. Ophthalmology. 1993 Nov;100(11):1677–1684. [PubMed] [Google Scholar]
- Fýrat P, Mocan G. Lymphoma presenting as a solitary mass: diagnosis by fine needle aspiration biopsy. Cytopathology. 2000 Aug;11(4):276–278. [PubMed] [Google Scholar]
- Levy-Clarke GA, Byrnes GA, Buggage RR, Shen DF, Filie AC, Caruso RC, Nussenblatt RB, Chan CC. Primary intraocular lymphoma diagnosed by fine needle aspiration biopsy of a subretinal lesion. Retina. 2001;21(3):281–284. [PubMed] [Google Scholar]
- Wilson DJ, Braziel R, Rosenbaum JT. Intraocular lymphoma. Immunopathologic analysis of vitreous biopsy specimens. Arch Ophthalmol. 1992 Oct;110(10):1455–1458. [PubMed] [Google Scholar]
- Davis JL, Viciana AL, Ruiz P. Diagnosis of intraocular lymphoma by flow cytometry. Am J Ophthalmol. 1997 Sep;124(3):362–372. [PubMed] [Google Scholar]
- Trainor KJ, Brisco MJ, Story CJ, Morley AA. Monoclonality in B-lymphoproliferative disorders detected at the DNA level. Blood. 1990 Jun 1;75(11):2220–2222. [PubMed] [Google Scholar]
- Linke B, Bolz I, Fayyazi A, von Hofen M, Pott C, Bertram J, Hiddemann W, Kneba M. Automated high resolution PCR fragment analysis for identification of clonally rearranged immunoglobulin heavy chain genes. Leukemia. 1997 Jul;11(7):1055–1062. [PubMed] [Google Scholar]
- Shen DF, Zhuang Z, LeHoang P, Böni R, Zheng S, Nussenblatt RB, Chan CC. Utility of microdissection and polymerase chain reaction for the detection of immunoglobulin gene rearrangement and translocation in primary intraocular lymphoma. Ophthalmology. 1998 Sep;105(9):1664–1669. [PubMed] [Google Scholar]
- Tuaillon N, Chan CC. Molecular analysis of primary central nervous system and primary intraocular lymphomas. Curr Mol Med. 2001 May;1(2):259–272. [PubMed] [Google Scholar]
- Benjamin D, Park CD, Sharma V. Human B cell interleukin 10. Leuk Lymphoma. 1994 Jan;12(3-4):205–210. [PubMed] [Google Scholar]
- Cortes J, Kurzrock R. Interleukin-10 in non-Hodgkin's lymphoma. Leuk Lymphoma. 1997 Jul;26(3-4):251–259. [PubMed] [Google Scholar]
- Fassone L, Gaidano G, Ariatti C, Vivenza D, Capello D, Gloghini A, Cilia AM, Buonaiuto D, Rossi D, Pastore C, et al. The role of cytokines in the pathogenesis and management of AIDS-related lymphomas. Leuk Lymphoma. 2000 Aug;38(5-6):481–488. [PubMed] [Google Scholar]
- Khatri VP, Caligiuri MA. A review of the association between interleukin-10 and human B-cell malignancies. Cancer Immunol Immunother. 1998 Jul;46(5):239–244. [PubMed] [Google Scholar]
- Banchereau J, Brière F, Liu YJ, Rousset F. Molecular control of B lymphocyte growth and differentiation. Stem Cells. 1994 May;12(3):278–288. [PubMed] [Google Scholar]
- Chan CC, Whitcup SM, Solomon D, Nussenblatt RB. Interleukin-10 in the vitreous of patients with primary intraocular lymphoma. Am J Ophthalmol. 1995 Nov;120(5):671–673. [PubMed] [Google Scholar]
- Whitcup SM, Stark-Vancs V, Wittes RE, Solomon D, Podgor MJ, Nussenblatt RB, Chan CC. Association of interleukin 10 in the vitreous and cerebrospinal fluid and primary central nervous system lymphoma. Arch Ophthalmol. 1997 Sep;115(9):1157–1160. [PubMed] [Google Scholar]
- Tritten JJ, Haefliger JM, Delouche D, Bovey E, Chan CC, Guex-Crosier Y, Herbort CP. Interleukine-10 et vitrite chronique dans un cas de lymphome oculaire. Klin Monbl Augenheilkd. 1998 May;212(5):416–417. [PubMed] [Google Scholar]
- Akpek EK, Maca SM, Christen WG, Foster CS. Elevated vitreous interleukin-10 level is not diagnostic of intraocular-central nervous system lymphoma. Ophthalmology. 1999 Dec;106(12):2291–2295. [PubMed] [Google Scholar]
- Michelson JB, Michelson PE, Bordin GM, Chisari FV. Ocular reticulum cell sarcoma. Presentation as retinal detachment with demonstration of monoclonal immunoglobulin light chains on the vitreous cells. Arch Ophthalmol. 1981 Aug;99(8):1409–1411. [PubMed] [Google Scholar]
- Chan CC, Shen D, Nussenblatt RB, Böni R, Zhuang Z. Detection of molecular changes in primary intraocular lymphoma by microdissection and polymerase chain reaction. Diagn Mol Pathol. 1998 Feb;7(1):63–64. [PubMed] [Google Scholar]
- White VA, Gascoyne RD, Paton KE. Use of the polymerase chain reaction to detect B- and T-cell gene rearrangements in vitreous specimens from patients with intraocular lymphoma. Arch Ophthalmol. 1999 Jun;117(6):761–765. [PubMed] [Google Scholar]
- Yunis JJ, Mayer MG, Arnesen MA, Aeppli DP, Oken MM, Frizzera G. bcl-2 and other genomic alterations in the prognosis of large-cell lymphoma. N Engl J Med. 1989 Apr 20;320(16):1047–1054. [PubMed] [Google Scholar]
- Hill ME, MacLennan KA, Cunningham DC, Vaughan Hudson B, Burke M, Clarke P, Di Stefano F, Anderson L, Vaughan Hudson G, Mason D, et al. Prognostic significance of BCL-2 expression and bcl-2 major breakpoint region rearrangement in diffuse large cell non-Hodgkin's lymphoma: a British National Lymphoma Investigation Study. Blood. 1996 Aug 1;88(3):1046–1051. [PubMed] [Google Scholar]
- Hermine O, Haioun C, Lepage E, d'Agay MF, Briere J, Lavignac C, Fillet G, Salles G, Marolleau JP, Diebold J, et al. Prognostic significance of bcl-2 protein expression in aggressive non-Hodgkin's lymphoma. Groupe d'Etude des Lymphomes de l'Adulte (GELA). Blood. 1996 Jan 1;87(1):265–272. [PubMed] [Google Scholar]
- Epstein MA. Epstein-Barr virus--discovery, properties and relationship to nasopharyngeal carcinoma. IARC Sci Publ. 1978;(20):333–345. [PubMed] [Google Scholar]
- Burkitt DP. The discovery of Burkitt's lymphoma. Cancer. 1983 May 15;51(10):1777–1786. [PubMed] [Google Scholar]
- Harrington DS, Weisenburger DD, Purtilo DT. Epstein-Barr virus--associated lymphoproliferative lesions. Clin Lab Med. 1988 Mar;8(1):97–118. [PubMed] [Google Scholar]
- Lyons SF, Liebowitz DN. The roles of human viruses in the pathogenesis of lymphoma. Semin Oncol. 1998 Aug;25(4):461–475. [PubMed] [Google Scholar]
- Otsuki T, Kumar S, Ensoli B, Kingma DW, Yano T, Stetler-Stevenson M, Jaffe ES, Raffeld M. Detection of HHV-8/KSHV DNA sequences in AIDS-associated extranodal lymphoid malignancies. Leukemia. 1996 Aug;10(8):1358–1362. [PubMed] [Google Scholar]
- Corboy JR, Garl PJ, Kleinschmidt-DeMasters BK. Human herpesvirus 8 DNA in CNS lymphomas from patients with and without AIDS. Neurology. 1998 Feb;50(2):335–340. [PubMed] [Google Scholar]
- Bashir R, Luka J, Cheloha K, Chamberlain M, Hochberg F. Expression of Epstein-Barr virus proteins in primary CNS lymphoma in AIDS patients. Neurology. 1993 Nov;43(11):2358–2362. [PubMed] [Google Scholar]
- Itoyama T, Sadamori N, Tsutsumi K, Tokunaga Y, Soda H, Tomonaga M, Yamamori S, Masuda Y, Oshima K, Kikuchi M. Primary central nervous system lymphomas. Immunophenotypic, virologic, and cytogenetic findings of three patients without immune defects. Cancer. 1994 Jan 15;73(2):455–463. [PubMed] [Google Scholar]
- Chan CC, Shen DF, Whitcup SM, Nussenblatt RB. Detection of human herpesvirus-8 and Epstein-Barr virus DNA in primary intraocular lymphomas. Blood. 1999 Apr 15;93(8):2749–2751. [PubMed] [Google Scholar]
- Shen DF, Herbort CP, Tuaillon N, Buggage RR, Egwuagu CE, Chan CC. Detection of Toxoplasma gondii DNA in primary intraocular B-cell lymphoma. Mod Pathol. 2001 Oct;14(10):995–999. [PubMed] [Google Scholar]
- Schultz C, Scott C, Sherman W, Donahue B, Fields J, Murray K, Fisher B, Abrams R, Meis-Kindblom J. Preirradiation chemotherapy with cyclophosphamide, doxorubicin, vincristine, and dexamethasone for primary CNS lymphomas: initial report of radiation therapy oncology group protocol 88-06. J Clin Oncol. 1996 Feb;14(2):556–564. [PubMed] [Google Scholar]
- DeAngelis LM. Primary CNS lymphoma: treatment with combined chemotherapy and radiotherapy. J Neurooncol. 1999 Jul;43(3):249–257. [PubMed] [Google Scholar]
- Hiraga S, Arita N, Ohnishi T, Kohmura E, Yamamoto K, Oku Y, Taki T, Sato M, Aozasa K, Yoshimine T. Rapid infusion of high-dose methotrexate resulting in enhanced penetration into cerebrospinal fluid and intensified tumor response in primary central nervous system lymphomas. J Neurosurg. 1999 Aug;91(2):221–230. [PubMed] [Google Scholar]
- Blay JY, Ongolo-Zogo P, Sebban C, Carrie C, Thiesse P, Biron P. Primary cerebral lymphomas: unsolved issues regarding first-line treatment, follow-up, late neurological toxicity and treatment of relapses. The FNCLCC. French Fédération Nationale des Centres de Lutte contre le Cancer. Ann Oncol. 2000;11 (Suppl 1):39–44. [PubMed] [Google Scholar]
- de Smet MD, Vancs VS, Kohler D, Solomon D, Chan CC. Intravitreal chemotherapy for the treatment of recurrent intraocular lymphoma. Br J Ophthalmol. 1999 Apr;83(4):448–451.[PMC free article] [PubMed] [Google Scholar]
- Fishburne BC, Wilson DJ, Rosenbaum JT, Neuwelt EA. Intravitreal methotrexate as an adjunctive treatment of intraocular lymphoma. Arch Ophthalmol. 1997 Sep;115(9):1152–1156. [PubMed] [Google Scholar]
- Henson JW, Yang J, Batchelor T. Intraocular methotrexate level after high-dose intravenous infusion. J Clin Oncol. 1999 Apr;17(4):1329–1329. [PubMed] [Google Scholar]
- de Smet MD. Management of non Hodgkin's intraocular lymphoma with intravitreal methotrexate. Bull Soc Belge Ophtalmol. 2001;(279):91–95. [PubMed] [Google Scholar]
- Soussain C, Suzan F, Hoang-Xuan K, Cassoux N, Levy V, Azar N, Belanger C, Achour E, Ribrag V, Gerber S, et al. Results of intensive chemotherapy followed by hematopoietic stem-cell rescue in 22 patients with refractory or recurrent primary CNS lymphoma or intraocular lymphoma. J Clin Oncol. 2001 Feb 1;19(3):742–749. [PubMed] [Google Scholar]
- Zhuang Z, Bertheau P, Emmert-Buck MR, Liotta LA, Gnarra J, Linehan WM, Lubensky IA. A microdissection technique for archival DNA analysis of specific cell populations in lesions < 1 mm in size. Am J Pathol. 1995 Mar;146(3):620–625.[PMC free article] [PubMed] [Google Scholar]
- Emmert-Buck MR, Bonner RF, Smith PD, Chuaqui RF, Zhuang Z, Goldstein SR, Weiss RA, Liotta LA. Laser capture microdissection. Science. 1996 Nov 8;274(5289):998–1001. [PubMed] [Google Scholar]
- Early P, Huang H, Davis M, Calame K, Hood L. An immunoglobulin heavy chain variable region gene is generated from three segments of DNA: VH, D and JH. Cell. 1980 Apr;19(4):981–992. [PubMed] [Google Scholar]
- Tonegawa S. Somatic generation of antibody diversity. Nature. 1983 Apr 14;302(5909):575–581. [PubMed] [Google Scholar]
- French DL, Laskov R, Scharff MD. The role of somatic hypermutation in the generation of antibody diversity. Science. 1989 Jun 9;244(4909):1152–1157. [PubMed] [Google Scholar]
- Chen YT, Whitney KD, Chen Y. Clonality analysis of B-cell lymphoma in fresh-frozen and paraffin-embedded tissues: the effects of variable polymerase chain reaction parameters. Mod Pathol. 1994 May;7(4):429–434. [PubMed] [Google Scholar]
- Chang Y, Cesarman E, Pessin MS, Lee F, Culpepper J, Knowles DM, Moore PS. Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi's sarcoma. Science. 1994 Dec 16;266(5192):1865–1869. [PubMed] [Google Scholar]
- Wright CF, Reid AH, Tsai MM, Ventre KM, Murari PJ, Frizzera G, O'Leary TJ. Detection of Epstein-Barr virus sequences in Hodgkin's disease by the polymerase chain reaction. Am J Pathol. 1991 Aug;139(2):393–398.[PMC free article] [PubMed] [Google Scholar]
- Burg JL, Grover CM, Pouletty P, Boothroyd JC. Direct and sensitive detection of a pathogenic protozoan, Toxoplasma gondii, by polymerase chain reaction. J Clin Microbiol. 1989 Aug;27(8):1787–1792.[PMC free article] [PubMed] [Google Scholar]
- Vieira P, de Waal-Malefyt R, Dang MN, Johnson KE, Kastelein R, Fiorentino DF, deVries JE, Roncarolo MG, Mosmann TR, Moore KW. Isolation and expression of human cytokine synthesis inhibitory factor cDNA clones: homology to Epstein-Barr virus open reading frame BCRFI. Proc Natl Acad Sci U S A. 1991 Feb 15;88(4):1172–1176.[PMC free article] [PubMed] [Google Scholar]
- Chan CC, Shen DF. Newer methodologies in immunohistochemistry and diagnosis. Dev Ophthalmol. 1999;31:1–13. [PubMed] [Google Scholar]
- Gunn MD, Ngo VN, Ansel KM, Ekland EH, Cyster JG, Williams LT. A B-cell-homing chemokine made in lymphoid follicles activates Burkitt's lymphoma receptor-1. Nature. 1998 Feb 19;391(6669):799–803. [PubMed] [Google Scholar]
- Legler DF, Loetscher M, Roos RS, Clark-Lewis I, Baggiolini M, Moser B. B cell-attracting chemokine 1, a human CXC chemokine expressed in lymphoid tissues, selectively attracts B lymphocytes via BLR1/CXCR5. J Exp Med. 1998 Feb 16;187(4):655–660.[PMC free article] [PubMed] [Google Scholar]
- DeAngelis LM, Yahalom J, Thaler HT, Kher U. Combined modality therapy for primary CNS lymphoma. J Clin Oncol. 1992 Apr;10(4):635–643. [PubMed] [Google Scholar]
- Liu K, Stern RC, Rogers RT, Dodd LG, Mann KP. Diagnosis of hematopoietic processes by fine-needle aspiration in conjunction with flow cytometry: A review of 127 cases. Diagn Cytopathol. 2001 Jan;24(1):1–10. [PubMed] [Google Scholar]
- Rousset F, Garcia E, Defrance T, Péronne C, Vezzio N, Hsu DH, Kastelein R, Moore KW, Banchereau J. Interleukin 10 is a potent growth and differentiation factor for activated human B lymphocytes. Proc Natl Acad Sci U S A. 1992 Mar 1;89(5):1890–1893.[PMC free article] [PubMed] [Google Scholar]
- Dukers DF, Jaspars LH, Vos W, Oudejans JJ, Hayes D, Cillessen S, Middeldorp JM, Meijer CJ. Quantitative immunohistochemical analysis of cytokine profiles in Epstein-Barr virus-positive and -negative cases of Hodgkin's disease. J Pathol. 2000 Feb;190(2):143–149. [PubMed] [Google Scholar]
- Petersson M, Charo J, Salazar-Onfray F, Noffz G, Mohaupt M, Qin Z, Klein G, Blankenstein T, Kiessling R. Constitutive IL-10 production accounts for the high NK sensitivity, low MHC class I expression, and poor transporter associated with antigen processing (TAP)-1/2 function in the prototype NK target YAC-1. J Immunol. 1998 Sep 1;161(5):2099–2105. [PubMed] [Google Scholar]
- Salazar-Onfray F. Interleukin-10: a cytokine used by tumors to escape immunosurveillance. Med Oncol. 1999 Jul;16(2):86–94. [PubMed] [Google Scholar]
- Shen L, Chiang AK, Liu WP, Li GD, Liang RH, Srivastava G. Expression of HLA class I, beta(2)-microglobulin, TAP1 and IL-10 in Epstein-Barr virus-associated nasal NK/T-cell lymphoma: Implications for tumor immune escape mechanism. Int J Cancer. 2001 Jun 1;92(5):692–696. [PubMed] [Google Scholar]
- Buggage RR, Whitcup SM, Nussenblatt RB, Chan CC. Using interleukin 10 to interleukin 6 ratio to distinguish primary intraocular lymphoma and uveitis. Invest Ophthalmol Vis Sci. 1999 Sep;40(10):2462–2463. [PubMed] [Google Scholar]
- Cassoux N, Merle-Beral H, Lehoang P, Herbort C, Chan CC. Interleukin-10 and intraocular-central nervous system lymphoma. Ophthalmology. 2001 Mar;108(3):426–427. [PubMed] [Google Scholar]
- Velez G, Buggage R. Interleukin-10 and intraocular-central nervous system lymphoma. Ophthalmology. 2001 Mar;108(3):427–428. [PubMed] [Google Scholar]
- Weaver DT. V(D)J recombination and double-strand break repair. Adv Immunol. 1995;58:29–85. [PubMed] [Google Scholar]
- Lewis SM, Agard E, Suh S, Czyzyk L. Cryptic signals and the fidelity of V(D)J joining. Mol Cell Biol. 1997 Jun;17(6):3125–3136.[PMC free article] [PubMed] [Google Scholar]
- Jacob J, Kelsoe G, Rajewsky K, Weiss U. Intraclonal generation of antibody mutants in germinal centres. Nature. 1991 Dec 5;354(6352):389–392. [PubMed] [Google Scholar]
- Liu YJ, Malisan F, de Bouteiller O, Guret C, Lebecque S, Banchereau J, Mills FC, Max EE, Martinez-Valdez H. Within germinal centers, isotype switching of immunoglobulin genes occurs after the onset of somatic mutation. Immunity. 1996 Mar;4(3):241–250. [PubMed] [Google Scholar]
- Lewis SM. The mechanism of V(D)J joining: lessons from molecular, immunological, and comparative analyses. Adv Immunol. 1994;56:27–150. [PubMed] [Google Scholar]
- Ramasamy I, Brisco M, Morley A. Improved PCR method for detecting monoclonal immunoglobulin heavy chain rearrangement in B cell neoplasms. J Clin Pathol. 1992 Sep;45(9):770–775.[PMC free article] [PubMed] [Google Scholar]
- Zelenetz AD, Chen TT, Levy R. Clonal expansion in follicular lymphoma occurs subsequent to antigenic selection. J Exp Med. 1992 Oct 1;176(4):1137–1148.[PMC free article] [PubMed] [Google Scholar]
- Matolcsy A, Schattner EJ, Knowles DM, Casali P. Clonal evolution of B cells in transformation from low- to high-grade lymphoma. Eur J Immunol. 1999 Apr;29(4):1253–1264.[PMC free article] [PubMed] [Google Scholar]
- Aarts WM, Bende RJ, Steenbergen EJ, Kluin PM, Ooms EC, Pals ST, van Noesel CJ. Variable heavy chain gene analysis of follicular lymphomas: correlation between heavy chain isotype expression and somatic mutation load. Blood. 2000 May 1;95(9):2922–2929. [PubMed] [Google Scholar]
- Bahler DW, Miklos JA, Swerdlow SH. Ongoing Ig gene hypermutation in salivary gland mucosa-associated lymphoid tissue-type lymphomas. Blood. 1997 May 1;89(9):3335–3344. [PubMed] [Google Scholar]
- Ottensmeier CH, Thompsett AR, Zhu D, Wilkins BS, Sweetenham JW, Stevenson FK. Analysis of VH genes in follicular and diffuse lymphoma shows ongoing somatic mutation and multiple isotype transcripts in early disease with changes during disease progression. Blood. 1998 Jun 1;91(11):4292–4299. [PubMed] [Google Scholar]
- Nakamura N, Kuze T, Hashimoto Y, Tasaki K, Hojo H, Sasaki Y, Sato M, Abe M. Analysis of the immunoglobulin heavy chain gene variable region of 101 cases with peripheral B cell neoplasms and B cell chronic lymphocytic leukemia in the japanese population. Pathol Int. 1999 Jul;49(7):595–600. [PubMed] [Google Scholar]
- Lossos IS, Tibshirani R, Narasimhan B, Levy R. The inference of antigen selection on Ig genes. J Immunol. 2000 Nov 1;165(9):5122–5126. [PubMed] [Google Scholar]
- Lossos IS, Okada CY, Tibshirani R, Warnke R, Vose JM, Greiner TC, Levy R. Molecular analysis of immunoglobulin genes in diffuse large B-cell lymphomas. Blood. 2000 Mar 1;95(5):1797–1803. [PubMed] [Google Scholar]
- Montesinos-Rongen M, Küppers R, Schlüter D, Spieker T, Van Roost D, Schaller C, Reifenberger G, Wiestler OD, Deckert-Schlüter M. Primary central nervous system lymphomas are derived from germinal-center B cells and show a preferential usage of the V4-34 gene segment. Am J Pathol. 1999 Dec;155(6):2077–2086.[PMC free article] [PubMed] [Google Scholar]
- Thompsett AR, Ellison DW, Stevenson FK, Zhu D. V(H) gene sequences from primary central nervous system lymphomas indicate derivation from highly mutated germinal center B cells with ongoing mutational activity. Blood. 1999 Sep 1;94(5):1738–1746. [PubMed] [Google Scholar]
- Julien S, Radosavljevic M, Labouret N, Camilleri-Broet S, Davi F, Raphael M, Martin T, Pasquali JL. AIDS primary central nervous system lymphoma: molecular analysis of the expressed VH genes and possible implications for lymphomagenesis. J Immunol. 1999 Feb 1;162(3):1551–1558. [PubMed] [Google Scholar]
- Liebowitz D. Epstein-Barr virus and a cellular signaling pathway in lymphomas from immunosuppressed patients. N Engl J Med. 1998 May 14;338(20):1413–1421. [PubMed] [Google Scholar]
- Cinque P, Brytting M, Vago L, Castagna A, Parravicini C, Zanchetta N, D'Arminio Monforte A, Wahren B, Lazzarin A, Linde A. Epstein-Barr virus DNA in cerebrospinal fluid from patients with AIDS-related primary lymphoma of the central nervous system. Lancet. 1993 Aug 14;342(8868):398–401. [PubMed] [Google Scholar]
- Bergmann M, Blasius S, Bankfalvi A, Mellin W. Primary non-Hodgkin lymphomas of the CNS-proliferation, oncoproteins and Epstein-Barr-virus. Gen Diagn Pathol. 1996 Mar;141(3-4):235–242. [PubMed] [Google Scholar]
- Chang Y, Moore PS. Kaposi's Sarcoma (KS)-associated herpesvirus and its role in KS. Infect Agents Dis. 1996 Oct;5(4):215–222. [PubMed] [Google Scholar]
- Antinori A, Larocca LM, Fassone L, Cattani P, Capello D, Cingolani A, Saglio G, Fadda G, Gaidano G, Ortona L. HHV-8/KSHV is not associated with AIDS-related primary central nervous system lymphoma. Brain Pathol. 1999 Apr;9(2):199–208. [PubMed] [Google Scholar]
- Russo JJ, Bohenzky RA, Chien MC, Chen J, Yan M, Maddalena D, Parry JP, Peruzzi D, Edelman IS, Chang Y, et al. Nucleotide sequence of the Kaposi sarcoma-associated herpesvirus (HHV8). Proc Natl Acad Sci U S A. 1996 Dec 10;93(25):14862–14867.[PMC free article] [PubMed] [Google Scholar]
- Smit RL, Baarsma GS, de Vries J. Classification of 750 consecutive uveitis patients in the Rotterdam Eye Hospital. Int Ophthalmol. 1993 Apr;17(2):71–76. [PubMed] [Google Scholar]
- Gilbert RE, Dunn DT, Lightman S, Murray PI, Pavesio CE, Gormley PD, Masters J, Parker SP, Stanford MR. Incidence of symptomatic toxoplasma eye disease: aetiology and public health implications. Epidemiol Infect. 1999 Oct;123(2):283–289.[PMC free article] [PubMed] [Google Scholar]
- Stein K, Hummel M, Korbjuhn P, Foss HD, Anagnostopoulos I, Marafioti T, Stein H. Monocytoid B cells are distinct from splenic marginal zone cells and commonly derive from unmutated naive B cells and less frequently from postgerminal center B cells by polyclonal transformation. Blood. 1999 Oct 15;94(8):2800–2808. [PubMed] [Google Scholar]
- Spencer J, Wotherspoon AC. Gastric MALT lymphoma and Helicobacter pylori. Cancer Surv. 1997;30:213–231. [PubMed] [Google Scholar]
- Bouzourene H, Haefliger T, Delacretaz F, Saraga E. The role of Helicobacter pylori in primary gastric MALT lymphoma. Histopathology. 1999 Feb;34(2):118–123. [PubMed] [Google Scholar]
- Nakamura S, Aoyagi K, Furuse M, Suekane H, Matsumoto T, Yao T, Sakai Y, Fuchigami T, Yamamoto I, Tsuneyoshi M, et al. B-cell monoclonality precedes the development of gastric MALT lymphoma in Helicobacter pylori-associated chronic gastritis. Am J Pathol. 1998 May;152(5):1271–1279.[PMC free article] [PubMed] [Google Scholar]
- Wotherspoon AC. A critical review of the effect of Helicobacter pylori eradication on gastric MALT lymphoma. Curr Gastroenterol Rep. 2000 Dec;2(6):494–498. [PubMed] [Google Scholar]
- Walt RP. Regression of MALT lymphoma and treatment for Helicobacter pylori. Lancet. 1996 Oct 12;348(9033):1041–1042. [PubMed] [Google Scholar]
- Montalban C, Manzanal A, Boixeda D, Redondo C, Alvarez I, Calleja JL, Bellas C. Helicobacter pylori eradication for the treatment of low-grade gastric MALT lymphoma: follow-up together with sequential molecular studies. Ann Oncol. 1997;8 (Suppl 2):37–39. [PubMed] [Google Scholar]
- Martin J, Boyle S, Jacyna M. Regression of a large gastric MALT lymphoma with antibiotic treatment to eradicate Helicobacter pylori. Postgrad Med J. 1997 Feb;73(856):109–110.[PMC free article] [PubMed] [Google Scholar]
- Falcó Jover G, Martínez Egea A, Sánchez Cuenca J, Onrubia Pintado J, García Lafuente N, Ruiz Gómez F, Coronas Planas M. Regression of primary gastric B-cell mucosa-associated lymphoid tissue (MALT) lymphoma after eradication of Helicobacter pylori. Rev Esp Enferm Dig. 1999 Aug;91(8):541–548. [PubMed] [Google Scholar]
- Miki H, Kobayashi S, Harada H, Yamanoi Y, Uraoka T, Sotozono M, Ohmori M. Early stage gastric MALT lymphoma with high-grade component cured by Helicobacter pylori eradication. J Gastroenterol. 2001 Feb;36(2):121–124. [PubMed] [Google Scholar]
- de Smet MD, Nussenblatt RB, Davis JL, Palestine AG. Large cell lymphoma masquerading as a viral retinitis. Int Ophthalmol. 1990 Oct;14(5-6):413–417. [PubMed] [Google Scholar]
- Matzkin DC, Slamovits TL, Rosenbaum PS. Simultaneous intraocular and orbital non-Hodgkin lymphoma in the acquired immune deficiency syndrome. Ophthalmology. 1994 May;101(5):850–855. [PubMed] [Google Scholar]
- Gass JD, Trattler HL. Retinal artery obstruction and atheromas associated with non-Hodgkin's large cell lymphoma (reticulum cell sarcoma). Arch Ophthalmol. 1991 Aug;109(8):1134–1139. [PubMed] [Google Scholar]
- Jenh CH, Cox MA, Hipkin W, Lu T, Pugliese-Sivo C, Gonsiorek W, Chou CC, Narula SK, Zavodny PJ. Human B cell-attracting chemokine 1 (BCA-1; CXCL13) is an agonist for the human CXCR3 receptor. Cytokine. 2001 Aug 7;15(3):113–121. [PubMed] [Google Scholar]
- Nagasawa T, Tachibana K, Kishimoto T. A novel CXC chemokine PBSF/SDF-1 and its receptor CXCR4: their functions in development, hematopoiesis and HIV infection. Semin Immunol. 1998 Jun;10(3):179–185. [PubMed] [Google Scholar]
- Murdoch C. CXCR4: chemokine receptor extraordinaire. Immunol Rev. 2000 Oct;177:175–184. [PubMed] [Google Scholar]
- Dürig J, Schmücker U, Dührsen U. Differential expression of chemokine receptors in B cell malignancies. Leukemia. 2001 May;15(5):752–756. [PubMed] [Google Scholar]
Abstract
PURPOSE: To evaluate immunoglobulin heavy chain (IgH) gene rearrangements, cytokines and chemokines, and infectious agents in primary intraocular B-cell lymphoma (PIOL) cells, in order to better diagnose and understand PIOL. METHODS: We studied ocular specimens from 57 patients with PIOL at the National Eye Institute from 1991 to 2001. Specimens were analyzed for IgH gene rearrangements using microdissection and polymerase chain reaction (PCR). We measured vitreal interleukin (IL)-10 and IL-6 levels by enzyme-linked immunosorbent assay. IL-10 mRNA was studied in PIOL cells using microdissection and reverse transcribed (RT)-PCR. Chemokine and chemokine receptor expression was examined by using immunohistochemistry. Infectious DNA of human herpetic virus-8 (HHV-8), Epstein-Bar virus (EBV), and Toxoplasma gondii was detected by using microdissection and PCR and was confirmed with Southern blot hybridization. RESULTS: IgH rearrangement(s) were demonstrated in all 50 tested cases. Cytokine levels were measured in the vitreous of 39 patients. Thirty-one had measurable cytokine levels: 24 of 31 had elevation of IL-10 relative to that of IL-6, and, in contrast, only 7 of 31 had elevation of IL-6 relative to IL-10. IL-10 mRNA was abundant in lymphoma cells of 6 examined cases. Lymphoma cells expressed chemokine receptors of CXCR4 and CXCR5 in three tested cases. HHV-8 DNA was found in 6 of 32 cases (18.8%), EBV DNA in 2 of 21 (9.5%), and T gondii DNA in 2 of 16 (12.5%). CONCLUSIONS: Molecular analyses detecting IgH rearrangements and vitreal levels of IL-10 and IL-6 are useful adjuncts for PIOL diagnosis. A role for specific infectious agents is hypothesized in the pathogenesis of some cases of PIOL. B-cell chemokine is likely involved in attracting PIOL cells into the eye.