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Blood, 15 January 2002, Vol. 99, No. 2, pp. 716-718
BRIEF REPORT
Follicular lymphoma with a novel t(14;18) breakpoint
involving the immunoglobulin heavy chain switch mu region
indicates an origin from germinal center B cells
James A. L. Fenton,
Jan-Willem Vaandrager,
Wilhelmina M. Aarts,
Richard J. Bende,
Karel Heering,
Martin van
Dijk,
Gareth Morgan,
Carel J. M. van Noesel,
Ed Schuuring, and
Philip M. Kluin
From the Department of Pathology, Leiden University
Medical Center, The Netherlands; Department of Haematology, University
of Leeds, United Kingdom; Department of Pathology, University of
Amsterdam, The Netherlands; Departments of Internal Medicine and
Clinical Pathology, Groene Hart Hospital, Gouda, The Netherlands.
With the use of DNA-fiber fluorescent in situ
hybridization, a BCL2 protein positive follicular lymphoma with
a novel BCL2 breakpoint involving the
immunoglobulin heavy chain (IGH) switch mu
(Sµ) region instead of the JH or
DH gene segments was identified. Sequence analysis showed that the genomic breakpoint is localized between the Sµ region of the IGH complex and
the first intron of BCL2. Reverse-transcriptase polymerase
chain reaction showed expression of a unique hybrid IGH-BCL2 transcript
involving the transcription initiation site Iµ. Sequence
analysis of the VH region of the functional nontranslocated
IGH allele showed multiple shared somatic mutations but
also a high intraclonal variation (53 differences in 15 clones),
compatible with the lymphoma cells staying in or re-entering the
germinal center. This is the first example of a t(14;18) translocation
that results from an illegitimate IGH class-switch
recombination during the germinal center B-cell stage.

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