Question

A lymphoma characterized by centrocytes and centroblasts, along with BCL2 positivity and CD10 expression, is most commonly associated with which chromosomal translocation?

• A. t(2;5)
• B. t(11;14)
• C. t(14;18)
• D. t(8;21)

Hint:

Follicular lymphoma = CD10 positive, BCL2 positive, t(14;18).

Answer 1

The Correct Option is C

Step 1: Understanding the Question:
The combination of specific cells (centrocytes/blasts) and markers (CD10, BCL2) identifies Follicular Lymphoma. The question asks for its characteristic translocation.
Step 2: Detailed Explanation:

Follicular Lymphoma: This is a B-cell lymphoma derived from germinal center cells. CD10 and BCL6 are germinal center markers.

t(14;18) Translocation: In over 90% of cases, there is a translocation between the BCL2 gene (chromosome 18) and the IgH locus (chromosome 14).

Pathogenesis: This places the BCL2 gene under the control of the highly active IgH promoter, leading to the overexpression of BCL2. BCL2 is an anti-apoptotic protein; its overexpression prevents programmed cell death in B-cells.

Differentials: t(11;14) is associated with Mantle Cell Lymphoma (Cyclin D1). t(8;14) is associated with Burkitt Lymphoma (c-MYC). t(2;5) is associated with ALK-positive Anaplastic Large Cell Lymphoma.

Step 3: Final Answer:
The hallmark of Follicular Lymphoma is the t(14;18) translocation leading to BCL2 overexpression.