Burkitt lymphoma

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Burkitt lymphoma, abbreviated BL, is an uncommon lymphoma with medium-sized cells.

General

  • Extremely high proliferative rate & rate of apoptosis.

Pathophysiology

  • Origin cell: germinal centre B cells (favoured) vs. memory B cells.[1]

Subtypes

  • Three subtypes recognized:[1]
  1. Endemic:
    • Found in Africa.
    • EBV (Epstein-Barr virus) associated.[1]
  2. Non-endemic:
    • Typical of the BL seen in the western world; EBV negative.
  3. Immunodeficiency associated:
    • Associated with HIV infection.

Microscopic

Features:

  • "Starry-sky pattern":
    • The stars in the pattern are: tingible-body macrophages.
      • Tingible-body macrophages = macrophages containing apoptotic tumour cells.
    • The tumour cells are the sky.
  • Tumour cells:[1]
    • Medium-sized (~1.5-2x the size of a RBC) with uniform size ("monotonous") -- key feature.
    • Round nucleus.
    • Small nucleoli.
    • Relatively abundant cytoplasm.
    • Brisk mitotic rate.

Images:

IHC

Features:

  • CD20 +ve.
  • CD10 +ve.
  • BCL6 +ve.
  • EBER +ve.

Others:

  • BCL2 -ve.

Cytologic definition

  • t(8;14) (q24;q32) translocation + a few variants or c-myc rearrangement.[1]

See also

References

  1. 1.0 1.1 1.2 1.3 1.4 Bellan C, Lazzi S, De Falco G, Nyongo A, Giordano A, Leoncini L (March 2003). "Burkitt's lymphoma: new insights into molecular pathogenesis". J. Clin. Pathol. 56 (3): 188–92. PMC 1769902. PMID 12610094. http://jcp.bmj.com/cgi/pmidlookup?view=long&pmid=12610094.