Transformation of follicular lymphoma to precursor B-cell lymphoblastic lymphoma with c-myc gene rearrangement as a critical event

Ken H. Young, Qingmei Xie, Guimei Zhou, Jens C. Eickhoff, Warren G. Sanger, Patricia Aoun, Wing C. Chan

Research output: Contribution to journalArticle

39 Scopus citations


Progression of follicular lymphoma (FL) to a higher-grade lymphoma occurs in 25% to 60% of cases and frequently indicates a poor prognosis. The transformation is accompanied by alteration in morphologic features and clinical behaviors. Herein, we report a case of FL occurring in a 59-year-old woman with the development of a precursor B-cell lymphoblastic lymphoma (PBC-LBL) during a 6-month period. Both lymphomas had identical bcl-2 and immunoglobulin heavy-chain gene breakpoints as assessed by polymerase chain reaction amplification and direct sequencing, indicating that the 2 tumors originated from a common precursor B-cell clone or the PBC-LBL arose from clonal evolution of its preceding FL and "dedifferentiated" into a lymphoblastic stage. Immunohistochemical studies revealed that both lymphomas displayed typical phenotypic characteristics. A c-myc gene translocation was observed in the PBC-LBL but not the FL by fluorescence in situ hybridization. The c-myc translocation is also reported in similar cases in the literature and likely is crucial in the pathogenesis of the PBC-LBL.

Original languageEnglish (US)
Pages (from-to)157-166
Number of pages10
JournalAmerican journal of clinical pathology
Issue number1
Publication statusPublished - Jan 1 2008



  • Follicular lymphoma
  • IgH
  • Lymphoblastic lymphoma
  • TP53
  • Transformation
  • bcl-2
  • bcl-6
  • c-myc

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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