Transformation of follicular lymphoma to plasmablastic lymphoma with c-myc gene rearrangement

Ihsane Ouansafi, Bing He, Cory Fraser, Kui Nie, Susan Mathew, Rumina Bhanji, Rana Hoda, Melissa Arabadjief, Daniel Knowles, Andrea Cerutti, Attilio Orazi, Wayne Tam

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38 Scopus citations


Follicular lymphoma (FL) is an indolent lymphoma that transforms to high-grade lymphoma, mostly diffuse large B-cell lymphoma, in about a third of patients. We present the first report of a case of FL that transformed to plasmablastic lymphoma (PBL). Clonal transformation of the FL to PBL was evidenced by identical IGH/BCL2 gene rearrangements and VDJ gene usage in rearranged IGH genes. IGH/ BCL2 translocation was retained in the PBL, which also acquired c-myc gene rearrangement. Genealogic analysis based on somatic hypermutation of the rearranged IGH genes of both FL and PBL suggests that transformation of the FL to PBL occurred most likely by divergent evolution from a common progenitor cell rather than direct evolution from the FL clone. Our study of this unusual case expands the histologic spectrum of FL transformation and increases our understanding of the pathogenetic mechanisms of transformation of indolent lymphomas to aggressive lymphomas.

Original languageEnglish
Pages (from-to)972-981
Number of pages10
JournalAmerican Journal of Clinical Pathology
Issue number6
StatePublished - Dec 2010


  • C-myc
  • Follicular lymphoma
  • Plasmablastic lymphoma
  • Transformation


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