An 8-year-old boy presents with a rapidly enlarging right mandibular mass. Biopsy shows sheets of medium-sized blasts interspersed with benign macrophages ingesting apoptotic tumour cells, giving a starry sky appearance. Which molecular event drives this tumour?

• A Overexpression of BCL2 due to t(14;18)
• B ALK kinase activation due to t(2;5)
• C Cyclin D1 overexpression due to t(11;14)
• D Constitutive c-MYC activation due to t(8;14) ✓

Explanation

Burkitt lymphoma, endemic in African children as a jaw mass and strongly linked to EBV, shows a starry sky pattern from tingible body macrophages. It is driven by translocation of MYC on chromosome 8 to the IgH locus via t(8;14), causing constitutive c-MYC expression and extremely high proliferation. t(14;18) with BCL2 defines follicular lymphoma, and t(11;14) defines mantle cell lymphoma.

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.