Fast Five Quiz: Follicular Lymphoma

Emmanuel C. Besa, MD

Disclosures

January 05, 2021

Figure 1. This light micrograph shows the typical follicular pattern of neoplasia.

Although we still do not fully understand how follicular lymphoma develops, the t(14;18) chromosomal translocation appears important. Present in about 85% of grade 1 and 2 cases, it can appear at a higher frequency than in the general population years before diagnosis. This aberration overexpresses the BCL2 proto-oncogene; affected cells no longer undergo apoptotic death and therefore survive longer. However, many healthy people appear to carry the translocation without consequence.

Polycyclic aromatic hydrocarbons, which are found in cigarette smoke, roofing tar, and car exhaust, among other sources, have been linked to cancers of the breast, skin, lung, bladder, and gastrointestinal tract.

Epstein-Barr virus and other viruses, including those causing hepatitis B and C, human T-cell lymphotropic virus type I, HIV, and human herpesvirus-8, have been linked to lymphomas, but usually to those that are diffuse or high-grade.

NDMA, a nitrosamine recently found to have contaminated batches of angiotensin II receptor blockers, the histamine-2 blocker ranitidine, and metformin, is known to be highly carcinogenic and hepatotoxic in rats. It is anticipated to be carcinogenic in humans but is not linked specifically to follicular lymphoma.

Learn more about follicular lymphoma.

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