Detection of t(2;5) in anaplastic large cell lymphoma: Comparison of immunohistochemical studies, FISH, and RT-PCR in paraffin-embedded tissue

Kimberley A. Cataldo, Syed M. Jalal, Mark E. Law, Stephen M. Ansell, David J. Inwards, Miriam Fine, Daniel A. Arber, Karen A. Pulford, John G. Strickler

Research output: Contribution to journalArticlepeer-review

98 Scopus citations


Anaplastic large cell lymphoma (ALCL) is associated with the t(2;5)(p23;q35) translocation involving the anaplastic lymphoma kinase gene (ALK) and the nucleophosmin gene (NPM), which result in expression of a novel fusion protein, NPM-ALK (p80). Clinicopathologic studies have shown that ALK expression in ALCL is associated with improved 5-year survival rates when compared with ALCL lacking ALK expression. This study used paraffin-embedded tissue to compare interphase fluorescence in situ hybridization (FISH) and reverse transcriptase-polymerase chain reaction (RT-PCR) for the detection of t(2;5) with immunohistochemical analysis for the detection of ALK protein expression in 27 patients with CD30-positive ALCLs. ALK protein expression was detected with ALK1 antibody in 14 of the 27 patients. The neoplastic cells in 13 of these 14 lymphomas reacted with the p80(NPM/ALK) antibody. FISH, using a two-color ALK DNA probe, correlated 100% with the immunohistochemical results: a translocation involving the ALK gene was detected in all 14 lymphomas that reacted with anti-ALK1. RT-PCR, performed on 21 lymphomas, detected NPM-ALK mRNA in five of the lymphomas, all of which reacted with anti-ALK1 and showed ALK gene rearrangement by FISH. Lymphomas showing ALK1 reactivity occurred in a younger patient population (median age, 19.5 years) and were associated with improved 5-year survival rates (84%), as compared with lymphomas lacking ALK1 reactivity (median age, 68.0 years; 5- year survival rate, 35%; p = 0.008). We conclude that immunohistochemical studies, using antibody ALK1, and FISH for ALK gene rearrangement are equally effective for identifying patients with ALCL who have a favorable clinical outcome.

Original languageEnglish (US)
Pages (from-to)1386-1392
Number of pages7
JournalAmerican Journal of Surgical Pathology
Issue number11
StatePublished - Nov 1 1999


  • Anaplastic lymphoma
  • Anaplastic lymphoma kinase
  • Fluorescence in situ hybridization
  • Reverse transcriptase-polymerase chain reaction

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine


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