Burkitt's Lymphoma (malignant lymphoma, small non-cleaved)

Major Clinical features

Usually seen in children, young adults, and immune-compromised patients

Male: female >1

Frequent extranodal involvement

Frequent bone marrow involvement (synonym to ALL-L3)

Major Morphology (Figure 16)

Diffuse lymph node involvement

Monotonous morphology with cells of uniform size and shape. The cytoplasm is scanty, the nucleus is round or slightly irregular with slightly coarse chromatin and several nucleoli.

Frequent mitotic figures

Presence of a starry sky appearance, imparted by scattered macrophages with phagoctyes cell debris

Oil red O positivity

Note: "Starry sky" pattern is not pathognomonic for Burkitt's lymphoma and may be observed in other highly proliferative lymphomas.

Major Immunophenotypic Features

Expression of B-Cell associated antigens CD19, CD20, CD22

Expression of CD10 and HLA-DR

Surface Ig, often IgM

Major cytogenetic and Molecular Studies

t(8;14), t(8;22), and t(2;8)
BCL-2 gene rearrangement

High-Grade B Cell Lymphoma, Burkitt-Like:

This term is suggested for those high grade lymphomas in which cell size and nuclear morphology are intermediate between large cell and Burkitt's lymphomas.

Tumor cells express B cell-associated antigens, are usually negative for CD5 and CD10, and may or may not express SIg. The bcl-2 is rearranged in about 30% of the cases and c-myc rearrangement is uncommon.

Selected References

Yano T, van Krieken JH, Magrath IT, et al: Histogenetic correlations between subcategories of small noncleaved cell lymphomas. Blood 79: 1282, 1992

Pavlova ZS, Parker JW, Taylor CR, et al: Small non-cleaved follicular center cell lymphoma: Burkitt's and non-Burkitt's variant in the US. II. Pathologic and immunologic features. Cancer 59: 1892, 1987

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