Starry sky pattern on biopsy is suggestive of Burkitt lymphoma

NEET PG Pathology
#1

BURKITT LYMPHOMA

  1. Features:
    30% of childhood NHL’s
    Mature B cell lymphoma
    Very aggressive
    Responds well to intensive chemotherapy

  2. Types:
    African
    Sporadic
    HIV associated

  3. Morphology:
    High mitotic index
    Contains numerous apoptotic cells
    Abundant clear cytoplasm
    Starry sky pattern of cytoplasm

  4. Immunophenotype:
    Express surface IgM, CD19, CD20, CD10, BCL6
    Fails to express anti-apoptotic protein BCL2

  5. Molecular pathogenesis:
    Associated with translocations of c-MYC gene on chromosome 8.
    Translocation partner is usually IgH locus

  6. Clinical manifestations:
    Extranodal sites
    Endemic: Mass involving mandible
    Sporadic: Mass involving ileocecum and peritoneum

  7. Treatment:
    Intensive combination chemotherapy regimens
    High doses of cyclophosphamide
    Prophylactic therapy to CNS