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The bcl-2 oncogene in Hodgkin's disease arising in the setting of
follicular non-Hodgkin's lymphoma
DP LeBrun, BY Ngan, LM Weiss, P Huie, RA Warnke and ML Cleary
Department of Pathology, Stanford University Medical Center, CA 94305.
Expression of the bcl-2 proto-oncogene on chromosome 18 is deregulated by
the 14; 18 chromosomal translocation, an abnormality that is consistently
associated with follicular non-Hodgkin's lymphomas (NHL). Because bcl-2 is
believed to function by prolonging cell survival rather than by increasing
proliferation, the presence of t(14; 18) in Hodgkin's disease (HD) would
have profound implications for the pathogenesis of this neoplasm. We
evaluated 32 cases of HD for t(14; 18) by polymerase chain reaction (PCR).
These results were correlated with expression of bcl-2 oncogenic protein by
Hodgkin cells and with the presence of Epstein-Barr virus (EBV), as
determined by immunohistochemistry or in situ hybridization. PCR provided
evidence of t(14; 18) in only 2 HD cases (6%), both of which were
associated with a prior history of follicular lymphoma, and both of which
were among the 7 cases (22%) with strong bcl-2 expression in Hodgkin cells.
In at least 1 of the cases, the translocation involved identical
chromosomal breakpoints in both types of lymphoma. Furthermore, 7
additional cases of combined follicular NHL and HD showed strong bcl-2
staining in Hodgkin cells. Although EBV was detected in 6 of 30 cases, it
was not associated with t(14; 18) and usually not with strong bcl-2
expression. These results suggest that a small proportion of HD cases might
evolve from follicular NHL, possibly through molecular events superimposed
on the t(14; 18). High-level bcl-2 expression in Hodgkin cells is a
potentially useful but not definitive marker for these cases.
Volume 83,
Issue 1,
pp. 223-230,
01/01/1994
Copyright © 1994 by The American Society of Hematology
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