The Retrospective Study And Evaluation Of Gene Rearrangements In Diagnosis Of Parotid Gland MALT Lymphoma

Objectives:To review the clinical and pathological manifestations of the parotid gland mucosa-associated lymphoid tissue(MALT)lymphoma and explore the relativity between parotid gland MALT lymphoma and Sjogren’s syndrome;to evaluate the diagnostic value of immunoglobulin(Ig)gene rearrangements.Methods:Clinical data of 21 patients referred to our institution between 2009 and 2017 were gathered and retrospectively analyzed.The paraffin-embedded tissue(8 suspected MALT lymphoma;13 suspected LEL;both diagnosed by histomorphology or/and IHC)were chosen for extracting genomic DNA and multiplex primer PCR amplification using BIOMED-2 primers.PCR amplification products were analyzed by heteroduplex analysis(HA).Results:Generally,17 patients were identified to be parotid gland MALT lymphoma and were alive so far;47.06%of them had Sjogren’s syndrome(SS)·Most patients had stage IE(80.9%)according to Ann Arbor staging system.IGH gene monoclonal rearrangements were detected in all cases,IGK monoclonal rearrangements detected in 58.82%cases.The sensitivity of IGH VH-JH FR1,FR2,FR3,IGK Vκ-Jκ,and IGK(Vκ-Kde and intron-Kde)as targets was 76.47%,82.35%,88.24%,29.41%,and 35.29%,respectively.Conclusion:Sjogren’s syndrome might closely associated with parotid gland MALT lymphoma.Ig clonal gene rearrangements assays using BIOMED-2 protocol can be a highly reliable diagnostic method for parotid gland MALT lymphoma.For patients with Sjogren syndrome along with histologically benign lymphoepithelial lesion,identification of Ig clonal gene rearrangements is important for routine differential diagnosis.