title: Translocations t(14;18) and t(8;14) with rearranged bcl-2 and c-myc in a case presenting as B-ALL (L3).
abstract: Follicular lymphoma is a low grade malignancy characterized by the translocation t(14;18), which involves the putative oncogene bcl-2. We describe a 73-year-old patient presenting with Burkitt acute lymphoblastic leukemia (B-ALL) L3 (Burkitt type), whose cells had the following immunophenotype: CD19+, CD22+, HLA-DR+, CD10+, TdT-, Cyt IgM-, CD34-. Analysis of 25 peripheral blood metaphases showed the presence of t(14;18) (q32;q21), and t(8;14) (q24;q32) in 24 cells and t(14;18) only in one cell, suggesting that the latter translocation came first during clonal evolution. Both bcl-2 and c-myc were rearranged in addition to the immunoglobulin heavy and light chain genes. The presence of small lymphoid cells in paratrabecular areas on the bone marrow biopsy, together with evidence of cytogenetic clonal evolution, was indicative of a transformation from a low grade follicular lymphoma to a more aggressive Burkitt type malignancy.
authors.affiliation: Academic Department of Haematology and Cytogenetics, Royal Marsden Hospital, London, UK.
authors.forename: V
authors.initials: V
authors.lastname: Brito-Babapulle
authors.forename: A
authors.initials: A
authors.lastname: Crawford
authors.forename: T
authors.initials: T
authors.lastname: Khokhar
authors.forename: M
authors.initials: M
authors.lastname: Laffan
authors.forename: E
authors.initials: E
authors.lastname: Matutes
authors.forename: S
authors.initials: S
authors.lastname: Fairhead
authors.forename: D
authors.initials: D
authors.lastname: Catovsky
mesh_terms: D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D002051:Burkitt Lymphoma / Q000235:genetics* / Q000276:immunology; D002883:Chromosomes, Human, Pair 14; D002887:Chromosomes, Human, Pair 18; D002898:Chromosomes, Human, Pair 8; D005260:Female; D015321:Gene Rearrangement; D016259:Genes, myc; D006801:Humans; D016133:Polymerase Chain Reaction; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D019253:Proto-Oncogene Proteins c-bcl-2; D011519:Proto-Oncogenes; D014178:Translocation, Genetic
chemical_list: D015703:Antigens, CD; D011518:Proto-Oncogene Proteins; D019253:Proto-Oncogene Proteins c-bcl-2