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Surgery General d2f4c319

A middle-aged man presents with a markedly enlarged tonsil and recurrent infections with serum immunoglobulin deficiency. Chromosome analysis demonstrates a translocation between the immunuglobulin heavy chain locus on chromosome 14 and an unidentified gene on chromosome 8. Which of the following is the most likely cause of his phenotype?

A
The translocation has deleted constant chain exons on chromosome 14 and prevented heavy chain class switching
B
The translocation has deleted the interval containing diversity d. and joining (J) regions
C
The translocation has activated a tumor-promoting gene on chromosome 8
D
The translocation has deleted the heavy chain constant chain Cu so that virgin B cells cannot produce IgM on their membranes
High-Yield Explanation
This case is an example of Burkitt's lymphoma, which may affect the tonsils or other lymphoid tissues. The translocation places the myc oncogene on chromosome 8 downstream of the very active heavy chain locus on chromosome 14, activating myc gene expression in B cells and their derivatives. The translocation is likely an aberrant form of the normal DNA rearrangements that generate unique heavy chain genes in each B cell. The translocation joins one chromosome 8 to one chromosome 14, leaving their homologues unaffected. The cause for the phenotype must therefore be trans-acting, since cis-acting effects would peain only to the translocated loci and not affect the homologous untranslocated loci. Activation of a tumor-promoting gene (oncogene) on chromosome 8 could produce an enlarged tonsil, while underactivity of immunoglobulin production due to one-half expression could decrease immune function but would not completely ablate the processes in choices a, b, d, and e. At the genetic level, trans-acting events are autosomal dominant in that one of the two homologous loci is abnormal and produces a phenotype. Mutations of cis-acting events must disrupt both homologous loci to produce phenotypes, making them autosomal recessive at the genetic level.

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