Immunoglobulin heavy chain rearrangements in primary brain lymphomas. A study using PCR to amplify CDR‐III

Primary brain lymphomas (PBLs) have only rarely been analysed for immunoglobulin heavy chain (IgH) rearrangements. In this study, DNA was extracted from paraffin blocks in 23 cases of PBL and examined for IgH rearrangements using the polymerase chain reaction (PCR) to amplify the complementarity‐determining region III (CDR‐III) of rearranged IgH genes. Fifteen of the cases were phenotyped on paraffin‐embedded tissue using a pan‐B and pan‐T antibody (L26 and UCHL‐1, respectively). The remaining eight cases were not phenotyped for lack of tissue. For comparison, we used DNA extracted from paraffin blocks of normal brain, lymph nodes with lymphoid hyperplasia, and non‐lymphoid malignancies. PCR products were examined by polyacrylamide gel electrophoresis. Among the ten B‐cell PBL; four had a pattern indicative of IgH rearrangement, one had a germline pattern, and five had no detectable PCR products. Among the five T‐cell PBLs, one had a germline pattern and four had no detectable products. Among the eight untyped PBLs, two had IgH rearrangement, four had a germline pattern, and two gave no detectable products. DNA from non‐lymphoid tissues gave a consistent germline pattern, while DNA from polyclonal lymphoid populations (lymph node) had a pattern of polyclonal IgH rearrangement. In a dilution study, a clonal rearrangement could be detected as long as the clone's DNA constituted at least 10 per cent of the total DNA. PCR to amplify CDR‐III can be successfully applied to DNA extracted from paraffin blocks, and it detected a clonal rearrangement in 50 per cent of cases that gave a detectable pattern. This allows clonality analysis of tissue unsuitable for conventional Southern blot analysis. Furthermore, B‐cell PBLs have IgH rearrangements similar to those of extracranial B‐cell neoplasms.