Haematology: follicular lymphoma: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Haematology: follicular lymphoma

Sample item

A 55-year-old woman has painless, waxing and waning lymphadenopathy for 2 years. Lymph node biopsy shows closely packed neoplastic follicles that lack tingible-body macrophages, and the cells carry t(14;18). What is the pathogenetic effect of this translocation?

AOverexpression of cyclin D1, driving the G1 to S transitionBOverexpression of MYC, driving proliferationCA constitutively active BCR-ABL tyrosine kinaseDOverexpression of BCL2, which blocks apoptosis

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Overexpression of BCL2, which blocks apoptosis

In follicular lymphoma the t(14;18) places the BCL2 gene under the control of the immunoglobulin heavy chain enhancer. BCL2 inhibits mitochondrial apoptosis, so the B cells accumulate by escaping death rather than by rapid division. The tumour is typically indolent but incurable, and it may transform to diffuse large B-cell lymphoma.

Option by option

A. Overexpression of cyclin D1, driving the G1 to S transition
Cyclin D1 overexpression results from t(11;14) in mantle cell lymphoma.
B. Overexpression of MYC, driving proliferation
MYC overexpression results from t(8;14) in Burkitt lymphoma.
C. A constitutively active BCR-ABL tyrosine kinase
BCR-ABL results from t(9;22) in chronic myeloid leukaemia.
D. Overexpression of BCL2, which blocks apoptosis (correct)
Correct. BCL2 overexpression blocks apoptosis and allows accumulation of centrocytes and centroblasts.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Overexpression of BCL2, which blocks apoptosis. In follicular lymphoma the t(14;18) places the BCL2 gene under the control of the immunoglobulin heavy chain enhancer.

Why is "Overexpression of cyclin D1, driving the G1 to S transition" not the answer?

Cyclin D1 overexpression results from t(11;14) in mantle cell lymphoma.

Why is "Overexpression of MYC, driving proliferation" not the answer?

MYC overexpression results from t(8;14) in Burkitt lymphoma.

Why is "A constitutively active BCR-ABL tyrosine kinase" not the answer?

BCR-ABL results from t(9;22) in chronic myeloid leukaemia.

What concept does this question test?

It tests Haematology: follicular lymphoma in Pathology. BCL2 inhibits mitochondrial apoptosis, so the B cells accumulate by escaping death rather than by rapid division. The tumour is typically indolent but incurable, and it may transform to diffuse large B-cell lymphoma.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology: follicular lymphoma?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.