Gene rearrangements in malignant lymphomas

Diagnosis and classification of malignant lymphomas is one of the most difficult and challenging problems encountered by pathologists today. Techniques for molecular genetic analysis have added an entirely new dimension to our understanding of the biology of the normal immune response. New knowledge of the mechanisms of DNA rearrangement in non-neoplastic T- and B-lymphoid cells has been exploited to provide information useful in the diagnosis and management of patients with lymphoid malignancies. The molecular techniques used to elucidate the rearrangement of normal antigen receptor genes have now been applied to the analysis of a large number of hyperplastic and malignant lymphoid proliferations, and the clinical utility of gene rearrangement studies in the malignant lymphomas has become well established. Gene rearrangement studies may yield information that is useful in establishing a definitive diagnosis of malignancy, in identifying the lineage of an immunophenotypically unclassifiable malignant population, or in providing data that are of value in predicting the clinical course, prognosis, or therapeutic response of an individual patient.