Experience with the BIOMED-2 standardized polymerase chain reaction protocol for immunoglobulin and T- cell receptor clonality analysis in the INC -Colombia

Introduction: The European BIOMED - 2 consortium was created to evaluate clonality in lymphoproliferations of difficult diagnosis. In Colombia, the implementation of these tests began in 2015 at the Instituto Nacional de Cancerologia ESE, Bogota, INC. Objectives: To determine the behavior of the rearrangement tests for lymphoid clonality and to know the difficulties for its implementation in our environment, a series of retrospective and consecutive cases of lymphoid proliferation subjected to the BIOMED-2 protocols is described. Materials and methods: Clinical and histological data and the results of the rearrangement analysis of all cases of lymphoid proliferation subjected to the BIOMED 2 protocols between February 2015 and May 2019 were collected from the clinical history. Results: 132 samples were recovered, of which 47 corresponded to reactive lymphoid hyperplasias, 62 to T lymphomas, 19 to B lymphomas and 3 to lymphoid neoplasms of not established lineage. In only one case did DNA extraction fail. The greatest diagnostic difficulty for the pathologist, according to these results, is the analysis of T lymphoid infiltrates, most of which (44) are skin lesions. Conclusions: Clonality tests are tests that can be used in tissues of different quality in our environment, and they contribute to the diagnosis of lymphoid proliferations that are difficult to classify. Finally, it is important to carry them out and interpret them in an interdisciplinary way, considering each case separately.