Publisher's Synopsis
The use of molecular techniques for establishing lymphocyte clonality has improved the diagnostic capabilities of laboratory medicine. While standardized primers have improved laboratory performance, there remains laboratory-to-laboratory variation in interpreting data. Both technical and biological issues can affect the interpretation of clonality. Lymphocyte Clonality Determination: A Case Study Approach presents specific cases to illustrate and discuss the difficulties that can arise when interpreting molecular clonality assays. Specific technical issues include: tissue fixation, pcr inhibitors, DNA extraction from different starting materials, amplicon fractionation methods, limited primer sets, background suppression and valid size ranges for amplicon distribution. Specific biological issues include: difficult tissue types (brain, skin, peripheral blood, bone, etc), Hodgkin lymphoma (low density of malignant cells), patients with autoimmune or rheumatologic diseases, patients with immunodeficiencies or immune suppression post-transplantation, clonality, pseudoclonality, oligoclonality and bigenotypic cases/lineage determinations. The volume provides, through case reports, examples of the authors laboratory's experience, over a three-year period, using state-of-the art molecular, immunohistochemistry, flow cytometetry, and microscopic data. This book will be most useful to both anatomic and clinical pathologists. Pathology residents, fellows, faculty and staff that are involved in interpreting molecular clonality assays will benefit from the case-based discussions in this textbook. Also medical students, clinical residents, fellows, faculty and staff in other areas such as hematology/oncology and dermatology that may desire a more in depth understanding of how clonality determinations are made for their patients will likely be interested in this book.
