Lineage Infidelity or Promiscuity

A potential pitfall in interpretation of molecular tests for AgR rearrangement in BCL is the occurrence of so-called lineage infidelity or promiscuity. This is particularly common in precursor B-cell malignancies but may also be seen in malignancies of mature B cells. The majority of precursor B-cell malignancies also show rearrangement of the TCRG gene. Only 5% to 10% of mature B-cell malignancies show TCR gene rearrangements, a finding that must be remembered to avoid erroneous conclusions about cell lineage.

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