Akasaka Takashi, Kishimori Chiyuki, Fukutsuka Katsuhiro, Nakagawa Miho, Takeoka Kayo, Hayashida Masahiko, Honjo Gen, Ohno Hitoshi
Department of Hematology, Tenri Hospital, Japan.
Tenri Institute of Medical Research, Japan.
Cancer Genet. 2017 Aug;214-215:26-31. doi: 10.1016/j.cancergen.2017.03.009. Epub 2017 Apr 4.
An 82-year-old woman presented with generalized lymphadenopathy and skin involvement. Lymph node biopsy revealed diffuse large B-cell lymphoma with a high proliferation index. G-banding and fluorescence in situ hybridization showed a hypertetraploid karyotype with two copies of t(8;22)(q24;q11), generating the fusion of MYC and the immunoglobulin λ chain gene (IGL), and two copies of the novel immunoglobulin heavy chain gene (IGH) translocation, t(14;15)(q32;q24). A long-distance inverse polymerase chain reaction (PCR) using nested primer combinations designed for each constant gene of IGH showed that Cγ4 was juxtaposed to the downstream sequence of the BCL2A1 (BCL2-related protein A1) gene through the Sγ4 switch region. As a result of t(14;15)(q32;q24), BCL2A1 and IGH Sγ4-Cγ4 were aligned in the same transcriptional orientation at a distance of 64 kb. Reverse transcriptase-mediated PCR showed high BCL2A1 mRNA levels in a lymphoma specimen. Since BCL2A1, mapped at 15q24.3 or 15q25.1, encodes a protein that is an anti-apoptotic member of the BCL2 protein family, we herein described the novel double-hit, t(8;22)(q24;q11)/MYC-IGL and t(14;15)(q32;q24)/IGH-BCL2A1, in which BCL2A1 is considered to play a role equivalent to that of BCL2 in the most frequent double-hit, MYC/BCL2.
一名82岁女性出现全身淋巴结肿大和皮肤受累。淋巴结活检显示为弥漫性大B细胞淋巴瘤,增殖指数高。G显带和荧光原位杂交显示为超四倍体核型,有两个t(8;22)(q24;q11)拷贝,导致MYC与免疫球蛋白λ链基因(IGL)融合,以及两个新的免疫球蛋白重链基因(IGH)易位拷贝,t(14;15)(q32;q24)。使用针对IGH每个恒定基因设计的巢式引物组合进行的长距离反向聚合酶链反应(PCR)表明,Cγ4通过Sγ4转换区与BCL2A1(BCL2相关蛋白A1)基因的下游序列并列。由于t(14;15)(q32;q24),BCL2A1和IGH Sγ4-Cγ4以相同的转录方向排列在64 kb的距离处。逆转录酶介导的PCR显示淋巴瘤标本中BCL2A1 mRNA水平高。由于定位于15q24.3或15q25.1的BCL2A1编码一种蛋白质,该蛋白质是BCL2蛋白家族的抗凋亡成员,我们在此描述了一种新的双打击,即t(8;22)(q24;q11)/MYC-IGL和t(14;15)(q32;q24)/IGH-BCL2A1,其中BCL2A1被认为在最常见的双打击MYC/BCL2中发挥与BCL2等效的作用。