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From the Department of Neuropathology,*
University of
Bonn Medical Center, Bonn; the Institute for Genetics and Department of
Internal Medicine I,
University of Cologne,
Cologne; the Department of Medical Microbiology and
Hygiene,
University of Heidelberg/Mannheim,
Mannheim; the Institute for Pathology,§
University of Frankfurt, Frankfurt; and the Department of
Neurosurgery,¶
University of Bonn Medical Center,
Bonn, Germany
Primary central nervous system lymphomas (PCNSLs) have recently
received considerable clinical attention due to their increasing
incidence. To clarify the histogenetic origin of these intriguing
neoplasms, PCNSLs from 10 HIV-negative patients were
analyzed for immunoglobulin (Ig) gene rearrangements. All tumors
exhibited clonal IgH gene rearrangements. Of the 10 cases, 5
used the V434 gene segment, and all of these
lymphomas shared an amino acid exchange from glycine to aspartate due
to a mutation in the first codon of the complementarity-determining
region 1. No preferential usage of
DH,
JH,
V
,
J
,
V
, or
J
gene segments was observed. All
potentially functional rearrangements exhibited somatic mutations. The
pattern of somatic mutations indicated selection of the tumor cells (or
their precursors) for expression of a functional antibody. Mean
mutation frequencies of 13.2% and 8.3% were detected for the heavy
and light chains, respectively, thereby exceeding other
lymphoma entities. Cloning experiments of three tumors showed ongoing
mutation in at least one case. These data suggest that PCNSLs are
derived from highly mutated germinal-center B cells. The frequent usage
of the V434 gene and the presence of a shared
replacement mutation may indicate that the tumor precursors recognized
a shared (super) antigen.
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