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Doctoral Thesis
DOI
10.11606/T.5.2007.tde-12022008-134944
Document
Author
Full name
Cláudia Zavaloni Melotti
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2007
Supervisor
Committee
Sanches Junior, Jose Antonio (President)
Amary, Maria Fernanda Carriel
Paes, Roberto Antônio Pinto
Rivitti, Evandro Ararigboia
Sotto, Mirian Nacagami
Title in Portuguese
Pesquisa do rearranjo dos genes das cadeias leve e pesada de imunoglobulina nos processos linfoproliferativos cutâneos de células B
Keywords in Portuguese
Cadeias leves de imunoglobulina
Cadeias pesadas de imunoglobulina
Linfócitos B
Linfoma/diagnóstico
Pele.
Pseudolinfoma
Reação em cadeia da polimerase
Abstract in Portuguese
INTRODUÇÃO: O diagnóstico diferencial dos processos linfoproliferativos cutâneos de célula B permanece um desafio para patologistas, dermatologistas, hematologistas e oncologistas, apesar dos recentes avanços imunoistoquímicos e moleculares. OBJETIVO: Este trabalho avaliou o auxílio diagnóstico e as limitações da pesquisa da clonalidade utilizando a biologia molecular nos linfomas primários cutâneos de célula B e pseudolinfomas de células B, assim como a relevância da análise dos dados em conjunto com informações clínicas, histológicas e imunoistoquímicas. MÉTODOS: O estudo incluiu 31 casos de processos linfoproliferativos cutâneos de célula B classificados à histologia e imunoistoquímica como 14 linfomas, 6 pseudolinfomas e 11 casos inconclusivos. A pesquisa da clonalidade foi realizada em todos os casos por meio da pesquisa do rearranjo dos genes da cadeia leve kappa e pesada utilizando o método de PCR. RESULTADOS: Os resultados confirmaram monoclonalidade em 61,5% dos linfomas. Em adição, o método evidenciou monoclonalidade em 20% dos casos inconclusivos à avaliação histológica e imunoistoquímica. A pesquisa do rearranjo dos genes de cadeia leve kappa resultou mais contributiva em relação à pesquisa do rearranjo dos genes da cadeia pesada. CONCLUSÕES: Estes resultados demonstraram a utilidade do método no auxilio diagnóstico dos linfomas cutâneos. A maior contribuição no estudo da clonalidade dos processos linfoproliferativos cutâneos de células B, através da pesquisa do rearranjo dos genes de cadeia leve kappa em associação com a pesquisa do rearranjo dos genes de cadeia pesada, sugeriu a necessidade da utilização conjunta das duas técnicas para maior acurácia diagnóstica nestes casos.
Title in English
Detection of immunoglobulin light and heavy chain genes rearrangements in cutaneous B cell lymphoproliferative infiltrates
Keywords in English
B lymphocytes
Immunoglobulin heavy chains
Immunoglobulin light chains
Lymphoma/diagnostic
Polymerase chain reaction
Pseudolymphomas
Skin.
Abstract in English
INTRODUCTION: The differential diagnosis of the lymphoproliferative B-cell infiltrates remains an important challenge for pathologists, dermatologists, hematologists and oncologists, despite the recent advances in immunohistochemical and molecular techniques. OBJECTIVES: This study has evaluated the diagnostic aid and the limitations of the clonality analysis using molecular biology in cutaneous B-cell lymphomas and pseudolymphomas, as well as the relevance of this analysis when combined with clinical, histological and immunohistochemical data. METHODS: The study covered 31 cases of cutaneous lymphoproliferative B-cell infiltrates classified by histological and immunohistochemical characteristics as 14 lymphomas, 6 pseudolymphomas and 11 non-conclusive cases. The clonality analysis was performed in all cases using PCR to detect the pattern of immunoglobulin light kappa and heavy chains gene rearrangements. RESULTS: The results have confirmed monoclonality in 61,5% of lymphomas. In addition, the method showed monoclonality in 20% of the cases previously classified as a non-conclusive through histological and immunohistochemical evaluation. CONCLUSION: These results highlight the importance of the PCR clonality analysis as an ancillary diagnostic tool in cutaneous lymphoma. The research of the immunoglobulin light kappa gene rearrangement was more efficient resulting in a higher rate of monoclonality detection when compared to the heavy chain analysis. Nevertheless, the use of both protocols improves the sensitivity of the method.
 
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ClaudiaZMelotti.pdf (3.11 Mbytes)
Publishing Date
2008-03-14
 
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