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Burkitt Lymphoma
Lessons From the Friday Unknowns
Histological sections show an enlarged lymph node effaced by a neoplastic lymphocytic proliferation with frequent mitotic figures and numerous tingible body macrophages imparting a “starry sky” pattern. Extensive extra capsular extension into the surrounding adipose tissue is noted.
The lymphoma cells are composed of monotonous medium sized cells with rounded nuclei, fine clumped chromatin, and basophilic scant cytoplasm. Extensive extra capsular extension into the surrounding adipose tissue is noted.
Immunohistochemical studies demonstrate that the lymphoma cells are positive for CD10, CD20, PAX5 and BCL6 expression. The lymphoma cells are negative for MUM1 and BCL-2 expression. The lymphoma shows a high Ki-67 proliferation index (> 95%).
Concurrent flow cytometry amalysis detected a clonal B-cell population expressing CD19, CD20, CD22 and CD45, and Lambda light chain.
FISH analysis detected MYC rearrangement (95.5%) and t(8;14) (93%). FISH was negative for BCL2 and BCL6 rearrangements.
In summary, these findings are supportive of the diagnosis of Burkitt lymphoma. If clinically appropriate, PCR test for Epstein-Barr virus is advisable.
Link to Digital Slides: https://bit.ly/3jaPyoz | Slides labeled case 4
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