An 8-year-old boy presents with a rapidly enlarging mass of the jaw. Biopsy shows sheets of medium-sized blasts with numerous apoptotic bodies phagocytosed by benign macrophages scattered through the tumour. The cells are germinal centre derived, CD10 positive, BCL6 positive, BCL2 negative. Which translocation is characteristic?

• A t(11;14) involving CCND1
• B t(14;18) placing BCL2 under the IgH promoter
• C t(8;14) placing MYC under the IgH promoter ✓
• D t(15;17) involving RARA

Explanation

The jaw mass in an African child, starry sky pattern from tingible body macrophages, and a germinal centre phenotype are classic for endemic Burkitt lymphoma. It results from t(8;14), which juxtaposes MYC with the immunoglobulin heavy chain locus, driving uncontrolled proliferation. BCL2 rearrangement via t(14;18) defines follicular lymphoma, whose hallmark is anti-apoptotic rather than proliferative drive, and Burkitt is characteristically BCL2 negative.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.