title: Concurrent development of "Burkitt-like" lymphoma and BCL-2-rearranged low-grade B cell lymphoma sharing the same germinal center origin.
abstract: B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma and Burkitt lymphoma (BL) is a new entity in WHO classification 2008, and includes Burkitt-like transformation of follicular lymphoma (FL). However, the pathological significance of BCL-2/IgH translocation, which is characteristic in FL, in newly diagnosed cases of this disease is not well understood. We report a patient who developed B cell lymphoma with BL-like morphology on the shoulder, whose bone marrow was involved with FL-like cells. BL-like tumor cells harbored amplified c-MYC genes with BCL-2/IgH translocation, but FL-like cells solely had BCL-2/IgH translocation. The sequence analysis of the IgH gene revealed both of cells originated from the same clone, showing that the aggressive BL-like tumor originated from the FL-like clones simultaneously found in the bone marrow. This case suggests that the IgH/BCL-2 translocation found in newly diagnosed Burkitt-like lymphoma indicates a history of FL-like indolent lymphoma, even if such history is not documented.
authors.affiliation: Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Motoshi
authors.initials: M
authors.lastname: Ichikawa
authors.forename: Akira
authors.initials: A
authors.lastname: Hangaishi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Imai
authors.forename: Mineo
authors.initials: M
authors.lastname: Kurokawa
mesh_terms: D000328:Adult; D002051:Burkitt Lymphoma / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D018858:Germinal Center / Q000473:pathology; D006801:Humans; D007143:Immunoglobulin Heavy Chains; D008224:Lymphoma, Follicular / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics*; D014178:Translocation, Genetic
chemical_list: D007143:Immunoglobulin Heavy Chains; D019253:Proto-Oncogene Proteins c-bcl-2