A 60-year-old man comes to the physician because of two painless masses in his neck, which he says appeared 4 months ago and are progressively increasing in size. The mass is nonpainful, and the patient has no associated dysphagia, chest pain, weight loss, or fever. He reports that his clothes have become looser over the past few months. He drinks alcohol occasionally. His temperature is 38.0°C (100.4°F), pulse is 90/min, and blood pressure is 105/60 mm Hg. Physical examination shows two nontender, fixed cervical lymph nodes on either side of the neck, which are approximately 2.2 cm and 4.5 cm in size. Biopsy of the mass reveals abnormal cells with a t(14;18) chromosomal translocation. This chromosomal change is most likely to cause which of the following abnormalities?

Question

A 60-year-old man comes to the physician because of two painless masses in his neck, which he says appeared 4 months ago and are progressively increasing in size. The mass is nonpainful, and the patient has no associated dysphagia, chest pain, weight loss, or fever.  He reports that his clothes have become looser over the past few months. He drinks alcohol occasionally. His temperature is 38.0°C (100.4°F), pulse is 90/min, and blood pressure is 105/60 mm Hg. Physical examination shows two nontender, fixed cervical lymph nodes on either side of the neck, which are approximately 2.2 cm and 4.5 cm in size. Biopsy of the mass reveals abnormal cells with a t(14;18) chromosomal translocation.  This chromosomal change is most likely to cause which of the following abnormalities?

Quizplus · Accepted Answer

Eductional Objective: Follicular lymphoma is a common, indolent non-Hodgkin lymphoma.  It is characterized by a translocation involving BCL2 on chromosome 18, which becomes positioned near the immunoglobulin heavy-chain gene on chromosome 14, resulting in overexpression of BCL2 (an antiapoptotic protein).

A 60-Year-Old Man Comes to the Physician Because of Two