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A patient develops an ovarian mass that is picked up on pelvic examination. Resection of the mass demonstrates a lymphoma composed of small lymphocytes with interspersed macrophages surrounded by clear spaces. This lesion would be most likely to be associated with which of the following?
Options:
A. abl-bcr hybrid
B. bcl-2 activation
C. c-myc activation
D. t(9,22)</SPAN></TD></TR>
E. t(14,18)
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The correct answer is C. The disease is Burkitt lymphoma (the major clue is the "starry sky" pattern described), which occurs as a jaw lesion in epidemic form in Africa (associated with Epstein-Barr virus) and in a sporadic form that usually involves the pelvic or abdominal organs. Burkitt lymphoma is associated with c-myc activation due to a t(8,14) translocation that places the c-myc-containing segment of chromosome 8 near an actively transcribed gene for immunoglobulin
heavy chains.
t(9,22) (choice D) and abl-bcr hybrid (choice A) are associated with chronic myeloid leukemia (CML).
t(14, 18) (choice E) and bcl-2 (choice B) are associated with follicular lymphomas, not Burkitt lymphoma.
