Burkitt Lymphoma in the Colon
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Lessons from the Friday Unknowns
H&E sections demonstrate colonic mucosa infiltrated by sheets of lymphoma cells.
The lymphoma cells are intermediate in size, have slightly irregular nuclear contours, finely condensed chromatin, multiple small paracentric nucleoli and basophilic cytoplasm.
Numerous atypical mitotic figures and apoptotic bodies are identified, the latter giving rise to a “starry sky” pattern.
Focal acute inflammation and ulceration is also noted.
Lymphoma cells are positive for CD20, PAX5, CD10 & BCL6; while negative for MUM1, BCL-2, CD30, BCL1, and EBER. Scattered T cells (CD3 positive) are noted in the background. C MYC: 95% — 100% of lymphoma cells are positive. Proliferation index (Ki-67): 95% — 100%.
FISH analysis is positive for MYC gene rearrangement; while negative for rearrangements of BCL 2 & BCL6 gene rearranegements.
These findings are supportive of the diagnosis of Burkitt lymphoma.
Link to digital slides: https://bit.ly/3lfQNU6| Slides labeled case 4
