A patient develops an ovarian mass that is picked up on pelvic examination. Resection of the mass demonstrates a lymphoma composed of small lymphocytes with interspersed macrophages surrounded by clear spaces. This lesion would be most likely to be associated with which of the following?
abl-bcr hybrid
bcl-2 activation
c-myc activation
t (9,22)
The condition is Burkitt lymphoma (the major clue is the "starry sky" pattern described), which occurs as a jaw lesion in epidemic form in Africa (associated with Epstein-Barr virus) and in a sporadic form that usually involves the pelvic or abdominal organs. Burkitt lymphoma is associated with c-myc activation due to a t (8,14) translocation that places the c-myc-containing segment of chromosome 8 near an actively transcribed gene for immunoglobulin heavy chains. t (9,22) and abl-bcr hybrid are associated with chronic myeloid leukemia (CML). t (14, 18) and bcl-2 are associated with follicular lymphomas, not Burkitt lymphoma.