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Malignant Lymphoma - high grade small non-cleaved cell type (Burkitts)
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Malignant Lymphoma - high grade small non-cleaved cell type (Burkitts)

A medium power view of a high grade, small cell lymphoma of the Burkitt type.
In this high power view, the two types of cells that comprise this tumor are clearly seen.
The malignant cells are the small packed cells that are deeply staining and seem to be composed entirely of nucleus.
In addition, larger cells that appear to be lying within lacunae are the tissue macrophages that are reacting to this proliferating cell.
(Description By:T.V.Rajan, M.D. )
(Image Contrib. by:T.V.Rajan, M.D. UCHC )
Burkitt's Lymphoma
Etiology

Epstein-Barr virus infection plays a role in African cases
Pathogenesis

In EBV associated disease, virus binds CD21 (B cell and oropharyngeal mucosa)and forms episomal latent infection without integration into the host genome.
Cells are immortalized via prevention of apoptosis
However, the step linking this viral infection to chromosome translocations and malignancy is not clear
Translocation with breakpoint on chromosome 8 and chromosome 14 (80% both kappa and lambda light chains), 2 (kappa light chains), and 22 (lambda light chains)is usualy found.
80% t(8;14)(q24;q32), 20% t(2;8)(p13;q24) or t(8;22)(q24:q11),
Epidemiology

African population of predominantly male children between 5 and 10 years living within 15 degrees north or south of the equator
Extranodal disease: jaw in African cases with peak at 3 years of age around developing molars; abdominal or pelvic organs particularly bowel in US cases
General Gross Description

May form large hemorrhagic soft masses
General Microscopic Description

Diffuse infiltrate of cells with moderate amount of cytoplasm and round to oval nuclei
Nuclei contain several prominent nucleoli
Apoptosis and high mitotic rate obvious
Numerous tingible-body macrophages containing lymphocyte debris are seen scattered throughout giving the low power "starry sky" appearance
Surface immunoglobulin, CD19, CD20, CD22, CD10, and CD21 positive (B cell antigens)
Clinical Correlation

Good response to aggressive chemotherapy
Classified as high grade lymphoma
References

Cotran RS, et.al : Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 640-642, 287-9.
Jaffe ES, Surgical Pathology of the Lymph Nodes and related organs, 2nd edition, Phil, Saunders, 1995, pp.313-319.
Burkitt's Lymphoma
Synopsis by: Melinda Sanders M.D. (T08000M97503)[330]
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