Which molecular event is the pathogenetic hallmark of follicular lymphoma, and what functional consequence does it produce?

• A t(11;14) causing cyclin D1 overexpression and uncontrolled proliferation
• B t(14;18) causing BCL2 overexpression with impaired apoptosis of germinal centre B cells ✓
• C MYC translocation causing markedly increased cellular proliferation rate
• D TP53 deletion causing genomic instability and transformation to aggressive disease

Explanation

Follicular lymphoma is characterised by t(14;18)(q32;q21), which places the anti-apoptotic BCL2 gene under the influence of the immunoglobulin heavy chain enhancer. The resulting constitutive BCL2 expression prevents apoptosis of germinal centre B cells that would otherwise die, explaining the accumulation of small cleaved centrocytes in neoplastic follicles. MYC translocation defines Burkitt lymphoma and drives proliferation, while cyclin D1 overexpression via t(11;14) is specific to mantle cell lymphoma.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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