Burkitt Lymphoma

Definition

Highly aggressive B lineage lymphoma frequently presenting in extranodal sites or as a leukemia, characterized by monomorphic medium sized cells with a very high proliferation rate

Uniform, round, medium sized nuclei
- Intermediate in size between small and large lymphoma cells
- Nucleoli multiple, central
- Coarse chromatin
- Plasmacytoid and atypical variants may show more nuclear pleomorphism
Thin but distinct rim of cytoplasm
- Typically appears to be "squared off" in tissue sections
- Amphophilic to basophilic
  - Velveteen and basophilic on Giemsa stain
- Small numbers of vacuoles on touch preps
- Plasmacytoid variant has eccentric basophilic cytoplasm
Very high mitotic rate
- Ki67 nearly 100%
- Many tingible body macrophages ("starry sky")
Diffse pattern of growth
- May preferentially involve germinal centers
Always B lineage
Frequent extranodal involvement
- GI tract, ovary, breast, kidney, central nervous system, peripheral blood
- Half of endemic cases involve facial bones
- HIV related cases frequently involve nodes or marrow
Variants

Yasodha Natkunam MD PhD
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342

Original posting:: Oct 11, 2007