The accurate diagnosis of Iymphoproliferative disorders which has important
therapeutic and pros-nostic implications may present diagnostic dilemma. Although
immunophenotyping has been of assistance in the diagnosis and classification of
Iymphoid malignancies, none of these immunophenotypic markers is specific for neoplasia
and phenotypic makers of clonality for T-cells are not available.
With the availability of molecular probes for immunoglobulin(Ig) and T-cell
receptor(TcR) genes, the clonality of Iymphoproliferative disorders can be investigated
by gene rearrangement stud-ies. And so, this approach has been used to distinguish
monoclonal from polyclonal proliferation and to determine the Iymphocytic lineage of
neoplasms lacking surface determinations.
We experienced a case of ALL which could not be exactly diagnosed by clinical,
cytomorphological and immunophfnotypic analysis. But at that time, this patient showed
distinct re-arrangement of Is heavy chain and TcR beta chain genes which is marker
for clonal Iymphoprolif-eration and 10 month later, typical features of common ALL(c -
ALL) was developed.
So, we wish to emphasize 19 and TcR gene rearrangement analysis to be important
ancillary tech-nique, particularly in the diagnosis of a subset of patients in whom
traditional methods fail to pro-duce conclusive evidence of clonality of Iymphoproliferaive
disorders.
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