USMLE · Question #589
A 50-year-old male comes to the physician complaining of neck masses that have been increasing in size for the past six months. He denies having any fevers or night sweats. Physical examination…
The correct answer is A. bcl-2 activation. Diffuse large B-cell lymphoma is derived from the B-cell line and the neoplastic cells resemble germinal center B cells. It may result from a follicular lymphoma. It is the most common type of non-Hodgkin lymphoma in adults but can occur in children. It results from alterations…
Question
A 50-year-old male comes to the physician complaining of neck masses that have been increasing in size for the past six months. He denies having any fevers or night sweats. Physical examination reveals bilateral, nontender cervical lymphadenopathy and hepatosplenomegaly. Biopsy of a cervical node reveals architectural distortion of the lymph node with proliferation of enlarged germinal follicles. Flow cytometry reveals a predominant cell population of CD, CD and CD - cells. The most likely cause of these findings is
Options
- Abcl-2 activation
- Bbcl-16 activation
- Cc-myc activation
- Dt(8;14)
- Et(9;22)
How the community answered
(31 responses)- A84% (26)
- B3% (1)
- D3% (1)
- E10% (3)
Explanation
Diffuse large B-cell lymphoma is derived from the B-cell line and the neoplastic cells resemble germinal center B cells. It may result from a follicular lymphoma. It is the most common type of non-Hodgkin lymphoma in adults but can occur in children. It results from alterations to the bcl-2 and bcl-6 proteins. The bcl-2 protein inhibits apoptosis, leading to prolonged cell survival. Patients may present with constitutional symptoms (low grade fever, weight loss, night sweats), nontender lymphadenopathy and the spleen, liver and bone marrow may be involved. The prognosis for diffuse large B-cell lymphoma is poor.
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