Journal of Pathology and Translational Medicine

Original Article

Utility of LymphoTrack for clonality testing in formalinfixed, paraffin-embedded tissue: integrated panel- and specimen-level comparison with fragment analysis: Ki-Chang Lee, Hyun-A Kim, Jiwon Koh, Jeong Mo Bae, Cheol Lee, Seung Geun Song, Yoon Kyung Jeon; Received September 2, 2026 Accepted October 2, 2026 Published online November 13, 2026; DOI: https://doi.org/10.4132/jptm.2026.10.02 [Epub ahead of print]

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Abstract PDF Supplementary Material: Background
Next-generation sequencing–based clonality assays provide sequence-level resolution but remain vulnerable to panel-specific failure in formalin-fixed, paraffin-embedded (FFPE) tissue. We evaluated LymphoTrack performance and integrated multi-panel interpretation. Methods: Seventeen FFPE specimens from 16 patients underwent 51 immunoglobulin heavy-chain (IGH) and 12 T-cell receptor (TCR) panel runs. Results were classified as Positive, Negative, or Fail and compared with lineage-level fragment-analysis interpretations. Panels targeting each lineage were integrated into specimen-level interpretations. Quality-control metrics associated with panel failure were explored. Results: Among 51 IGH panel runs, 37 (72.5%) were concordant, four (7.8%) discordant, and 10 (19.6%) Fail; all Fail results occurred in FR1 or FR2. IGH specimen-level agreement was 16/17 (94.1%; 95% confidence interval [CI], 73.0% to 99.0%). LymphoTrack classified four IGH specimens as monoclonal and 13 as polyclonal, including six based on incomplete panel coverage. One such specimen (FR1/FR2 Fail and FR3 Negative) was discordant with monoclonal fragment analysis. TCR specimen-level agreement was 5/6 (83.3%; 95% CI, 43.6% to 97.0%). In the discordant TCR specimen, T-cell receptor gamma (TRG) fragment analysis was oligoclonal, whereas both LymphoTrack TRG and T-cell receptor beta were Positive. A post–polymerase chain reaction library concentration threshold of ≤4.5 ng/μL identified all Fail panels but had limited specificity (58.5%) and precision (31.3%). Conclusions: LymphoTrack showed high specimen-level agreement with fragment analysis despite panel-specific technical vulnerability in FFPE tissue. Partial panel failure had asymmetric implications: a Positive panel preserved a monoclonal interpretation, whereas polyclonal results with incomplete panel coverage remained vulnerable to discordance. Reporting incomplete panel coverage may help communicate this limitation.

Case Study

Primary Peripheral Gamma Delta T-Cell Lymphoma of the Central Nervous System: Report of a Case Involving the Intramedullary Spinal Cord and Presenting with Myelopathy: Jeemin Yim, Seung Geun Song, Sehui Kim, Jae Won Choi, Kyu-Chong Lee, Jeong Mo Bae, Yoon Kyung Jeon; J Pathol Transl Med. 2019;53(1):57-61. Published online October 1, 2018; DOI: https://doi.org/10.4132/jptm.2018.08.21

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Primary central nervous system lymphoma of T-cell origin (T-PCNSL) is rare, and its clinicopathological features remain unclear. Peripheral T-cell lymphoma of γδ T-cell origin is an aggressive lymphoma mainly involving extranodal sites. Here, we report a case of γδ T-PCNSL involving the intramedullary spinal cord and presenting with paraplegia. A 75-year-old Korean woman visited the hospital complaining of back pain and lower extremity weakness. Magnetic resonance imaging revealed multifocal enhancing intramedullary nodular lesions in the thoracic and lumbar spinal cord. An enhancing nodular lesion was observed in the periventricular white matter of the lateral ventricle in the brain. There were no other abnormalities in systemic organs or skin. Laminectomy and tumor removal were performed. The tumor consisted of monomorphic, medium-to-large atypical lymphocytes with pale-to-eosinophilic cytoplasm. Immunohistochemically, the tumor cells were CD3(+), TCRβF1(-), TCRγ(+), CD30(-), CD4(-), CD8(-), CD56(+), TIA1(+), granzyme B(+), and CD103(+). Epstein-Barr virus in situ was negative. This case represents a unique T-PCNSL of γδ T-cell origin involving the spinal cord.

Citations

Citations to this article as recorded by

B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review
Daniel Gregório Gonsalves, Paulo Eduardo Albuquerque Zito Raffa, Gabriela Gerenutti de Sousa, Melissa Esposito Gomes Rigueiral, Iracema Araújo Estevão, Cesar Cozar Pacheco, Roger Thomaz Rotta Medeiros, Paulo Roberto Franceschini, Paulo Henrique Pires de A
Asian Journal of Neurosurgery.2023; 18(02): 231. CrossRef
Primary intramedullary spinal cord lymphoma misdiagnosed as longitudinally extensive transverse myelitis: a case report and literature review
Huizhen Ge, Li Xu, Huajie Gao, Suqiong Ji
BMC Neurology.2023;[Epub] CrossRef
Clinicopathologic and Genetic Features of Primary T-cell Lymphomas of the Central Nervous System
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American Journal of Surgical Pathology.2022; 46(4): 486. CrossRef
Peripheral T-Cell Lymphomas Involving the Central Nervous System: A Report From the Czech Lymphoma Study Group Registry
Heidi Mocikova, Robert Pytlík, Katerina Benesova, Andrea Janikova, Juraj Duras, Alice Sykorova, Katerina Steinerova, Vit Prochazka, Vit Campr, David Belada, Marek Trneny
Frontiers in Oncology.2022;[Epub] CrossRef

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