Abstract
Polymerase chain reaction (PCR) based automated high-resolution fragment analysis of rearranged immunoglobulin heavy-chain genes is a highly sensitive means for identifying clonal B-cell responses. We used this technique to distinguish polyclonal inflammatory from monoclonal neoplastic B-cell populations in the cerebrospinal fluid (CSF) of three patients with acute demyelinating disorders of the central nervous system whose clinical, magnetic resonance imaging (MRI) and CSF features did not permit unequivocal exclusion of primary central nervous system lymphoma (pC-NSL). This approach is highly suitable for detecting CNS inflammation particularly when lymphomatous involvement cannot be ruled out by noninvasive diagnostic procedures alone.
Publication types
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Case Reports
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Clinical Trial
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Research Support, Non-U.S. Gov't
MeSH terms
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Acute Disease
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Adult
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B-Lymphocytes / cytology
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B-Lymphocytes / physiology
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Central Nervous System Neoplasms / cerebrospinal fluid*
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Central Nervous System Neoplasms / genetics*
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Central Nervous System Neoplasms / physiopathology
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Complementarity Determining Regions / cerebrospinal fluid
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Complementarity Determining Regions / genetics
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Complementarity Determining Regions / physiology
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Demyelinating Diseases / cerebrospinal fluid*
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Demyelinating Diseases / genetics*
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Demyelinating Diseases / physiopathology
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Electrophoresis, Capillary
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Female
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Humans
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Immunoglobulin Heavy Chains / cerebrospinal fluid
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Immunoglobulin Heavy Chains / genetics
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Immunoglobulin Heavy Chains / physiology
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Lymphoma / cerebrospinal fluid*
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Lymphoma / genetics*
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Lymphoma / physiopathology
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Male
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Polymerase Chain Reaction
Substances
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Complementarity Determining Regions
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Immunoglobulin Heavy Chains