In healthy humans, 60-70% of the B lymphocytes produce kappa light chains, while the remaining cells produce lambda light chains. Malignant transformation and clonal expansion of B lymphocytes lead to an altered kappa : lambda expression ratio, which is an important diagnostic criteria of lymphomas. Here, we compared three methods for clonality determination of suspected B cell lymphomas. Tumor biopsies from 55 patients with B cell malignancies, 5 B-lymphoid tumor cell lines, and 20 biopsies from patients with lymphadenitis were analyzed by immunohistochemistry, flow cytometry, and reverse transcription quantitative real-time PCR. Clonality was determined by immunohistochemistry in 52/53 cases, flow cytometry in 30/39 cases, and reverse transcription quantitative real-time PCR in 33/55 cases. In conclusion, immunohistochemistry was superior to flow cytometry and reverse transcription quantitative real-time PCR for clonality identification. Flow cytometry and reverse transcription quantitative real-time PCR analysis has complementary values. In a considerable number of cases tumor cells produced both kappa and lambda light chain transcripts, but only one type of light chain peptide was produced.

Fujirebio Diagnostics AB Elof Lindälvs Gata 13 402 42 Gothenburg Sweden

Sahlgrenska Cancer Center Sahlgrenska Academy University of Gothenburg 405 30 Gothenburg Sweden

Sahlgrenska Cancer Center Sahlgrenska Academy University of Gothenburg 405 30 Gothenburg Sweden ; TATAA Biocenter Odinsgatan 28 411 03 Gothenburg Sweden

TATAA Biocenter Odinsgatan 28 411 03 Gothenburg Sweden

TATAA Biocenter Odinsgatan 28 411 03 Gothenburg Sweden ; Institute of Biotechnology AS CR Videnska 1083 142 20 Prague 4 Czech Republic

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