Activation-induced cytidine deaminase (AID ⁄ AICDA) is required for somatic hypermutation and class-switch recombination of the immunoglobulin gene, and for c-myc translocation of germinal center-derived B-cell lymphoma. In the present study, we attempted to clarify the significance of AID associated with c-myc in the progression of follicular lymphoma (FL) using RT-PCR and quantitative real-time PCR. Tissues from the patients with grade 3 FL expressed relatively higher levels of c-myc and AID. The samples taken from a patient with FL who died within 2 years after the start of treatment showed either no or low expression of AID, despite expressing high levels of c-myc. In order to examine the role of AID expression in rapidly progressive FL, the full-length AID transcript was transfected into AID-negative cell lines established from different patients with rapidly progressive FL. This led to the establishment of AID-expressing transfectants with a low proliferation rate and a significantly increased incidence of G 0 ⁄ G 1 arrest compared with controls. Our results indicate that AID may act as a negative regulator of cell survival in FL when sufficient c-myc is expressed. Switch-off or low expression of AID after c-myc amplification may correlate with the clinical outcomes of FL. (Cancer Sci 2012; 103: 415-421) F ollicular lymphoma is the most common type of low-grade lymphoma, accounting for approximately 22% of all nonHodgkin's lymphomas, and shows an indolent clinical course in up to 70% of cases.(1,2) Its cell origin is normal GCB lymphocytes with ongoing SHM of the Ig gene in association with AID ⁄ AICDA.(3-5) FL cells are typically positive for bcl-2 protein. Approximately 75-90% of FL cells have a t(14;18)(q32;q21) translocation, which is the recognized hallmark for diagnosis of FL.(6) Although this translocation is thought to be associated with oncogenic change, it is not sufficient to cause FL, because IgHbcl-2 transgenic mice do not develop lymphomas, and IgH-bcl-2 translocation can be detected in peripheral blood lymphocytes from healthy individuals. (7)(8)(9) Follicular lymphoma can show histological transformation into diffuse aggressive lymphoma during the clinical course in approximately 30% of patients. (10,11) This transformation is usually associated with acceleration of the clinical course. (12) Transformed FLs generally retain the t(14;18) translocation, (13) and it is believed that other genetic abnormalities are necessary in order for this transformation to occur. These secondary genetic events associated with histological transformation include c-myc amplification and translocation, (14,15) bcl-6 translocation, (16) TP53 mutation, (17) P16 gene inactivation,and c-REL amplification. (19) A series of reports has documented dual-translocation lymphoma harboring both bcl-2 and c-myc translocation, and some of the reported cases have a history of preceding FL. (20,21) C-myc translocation occurs in almost all BLs, (22) 5-15% of DLBCLs, and 2-3% of FLs.(23-25) Although rare cases of histologic...