title: Precursor B-lymphoblastic transformation of grade I follicle center lymphoma.
abstract: Part of the natural history of follicle center lymphoma (FCL) is transformation to a more aggressive neoplasm, almost always a diffuse large B-cell lymphoma. We describe a rare example of a precursor B-lymphoblastic transformation of grade I FCL occurring in a 45-year-old woman 12 years after initial presentation and 3 years after successful treatment for a diffuse large cell transformation. The lymphoblastic lymphoma shared the same immunoglobulin heavy chain gene rearrangement as the FCL as assessed by polymerase chain reaction amplification and direct sequencing, as well as identical kappa light chain gene rearrangements by Southern blot analysis. The immunoglobulin heavy chain variable gene sequences of both tumors showed numerous identical base substitutions compared with germline sequences and 3 additional mutations in the lymphoblastic lymphoma not present in the low-grade FCL. These results indicate origin of the lymphoblastic process from the mature follicle center B-cell clone, rather than divergent origin of the 2 tumors from a common immature B-cell precursor.
authors.affiliation: Department of Pathology, University of Texas Southwestern Medical Center, Dallas 75235-9073, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Kroft
authors.forename: R
authors.initials: R
authors.lastname: Domiati-Saad
authors.forename: W G
authors.initials: WG
authors.lastname: Finn
authors.forename: D B
authors.initials: DB
authors.lastname: Dawson
authors.forename: B
authors.initials: B
authors.lastname: Schnitzer
authors.forename: T P
authors.initials: TP
authors.lastname: Singleton
authors.forename: C W
authors.initials: CW
authors.lastname: Ross
mesh_terms: D000328:Adult; D001483:Base Sequence; D015139:Blotting, Southern; D002471:Cell Transformation, Neoplastic / Q000235:genetics / Q000473:pathology*; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain / Q000235:genetics; D015328:Gene Rearrangement, B-Lymphocyte, Light Chain / Q000235:genetics; D005803:Genes, Immunoglobulin / Q000235:genetics; D019254:Genes, bcl-2 / Q000235:genetics; D006801:Humans; D007124:Immunoenzyme Techniques; D007135:Immunoglobulin Variable Region / Q000235:genetics; D007145:Immunoglobulin kappa-Chains / Q000235:genetics; D016393:Lymphoma, B-Cell / Q000235:genetics / Q000473:pathology*; D008224:Lymphoma, Follicular / Q000235:genetics / Q000473:pathology*; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics / Q000473:pathology*
chemical_list: D004273:DNA, Neoplasm; D007135:Immunoglobulin Variable Region; D007145:Immunoglobulin kappa-Chains