Transformation of follicular lymphoma to Burkitt-like lymphoma within a single lymph node

Aberrant expression of bcl-2, caused by a t(14;18) translocation, is most commonly associated with follicular lymphoma. In a subset of these tumors, additional acquisition of a translocation involving c-myc leads to transformation to a high-grade lymphoma. We report a case of follicular lymphoma containing a t(14;18) translocation transforming into a Burkitt-like lymphoma containing the original t(14;18) as well as an additional t(8;14). The latter translocation resulted in the phenotype of Burkitt-like lymphoma, and the transformation from follicular lymphoma to Burkitt-like lymphoma was demonstrable within a single lymph node. To the best of our knowledge, this is the first report of a case documenting direct transformation of follicular lymphoma into Burkitt-like lymphoma in the same lymph node. This case illustrates the dramatic oncogenic stimulus that results from the inhibition of apoptosis by bcl-2 combined with the deregulation of cell growth by c-myc.