Detection of the t(14;18) chromosomal translocation from fine-needle aspiration in
follicular lymphoma and the significance of so called molecular nodal remission
Janíková-Obořilová A., Mayer J., Křen L.,1 Kroupová I.,1 Šmardová J.,1 Dvořáková D., Mejstřík P., Neubauer J.,2 Vášová I.
Interní hematoonkologická klinika FN Brno, 1Patologicko anatomický ústav FN Brno, 2Radiodiagnostická klinika FN Brno |
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Summary:
Aim: To prove, if fine needle aspiration (FNA) is sufficient for detection of t(14;18) in lymph node infiltrated by follicular
lymphoma (FL). To determine value of molecular remission in lymph node in patients in complete and molecular
remission. Methods: First we tested t(14;18) in paired-specimens taken by FNA and by classical biopsy (from
autopsies and operation biopsies). We continued to perform FNAs guided by ultrasound (US) in patients with easy
accessible lymphadenopathy, t(14;18) was tested by FISH (fluorescent in situ hybridization) and by PCR (polymerase
chain reaction). FNA of near the same lymph node was repeated in suitable patients in complete (CR) and molecular
remission. Results: We tested for t(14;18) 22 paired samples (FNA vs. biopsy). 1/22 (4.5 %) FNA was negative
compared to the biopsy. 31 FNA of lymph node guided by US were done, success of FNA was 100 % in advanced FL.
FISH identified t(14;18) in 89 %, PCR in 67 %. 12 cases of FNA were done in CR (CT and PET) and molecular
remission in blood (PCR): in 4/12 cases samples were not taken for technical reason, in 3/12 FNA fibrosis was detected.
6/7 patients with non-diagnostic FNA are in remission (median 19 months), 1 patient relapsed. 5/12 FNA were
diagnostic (in 4 patients), t(14;18) was identified in 5/5 (100%) cases. 3 patients relapsed 3, 6 and 12 months later, 1
patient remains in remission (>20 months), in spite of repeated FNA identified t(14;18) after 12 months again. Conclusion:
FNA is potentially suitable for detection t(14;18) in lymph nodes in FL. Persistence of t(14;18) in lymph node
in CR is relatively frequent and this could be considered as real minimal residual disease. Further study is needed
to define its biological importance, because persistence of t(14;18) in lymph node does not mean clinical relapse.
Key words:
t(14;18), follicular lymphoma, fine needle aspiration, minimal residual disease, FISH, PCR
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