A 28-year-old man presents with rapidly enlarging jaw mass. Biopsy shows a 'starry sky' pattern with medium-sized lymphocytes having basophilic cytoplasm and multiple nucleoli. FISH shows MYC/IGH rearrangement. The Ki-67 proliferation index is nearly 100%. According to WHO 2022 classification, this lymphoma is now called:

• A Diffuse large B-cell lymphoma, NOS
• B Burkitt lymphoma ✓
• C Double-hit lymphoma
• D Mantle cell lymphoma

Explanation

The morphology (medium-sized cells, 'starry sky' due to apoptotic debris engulfed by macrophages, basophilic cytoplasm, multiple small nucleoli), near-100% Ki-67 index, and MYC/IGH rearrangement [t(8;14)] confirm Burkitt lymphoma. In WHO 2022 classification, Burkitt lymphoma retains this designation. Double-hit lymphoma (now called high-grade B-cell lymphoma with MYC and BCL2/BCL6 rearrangements) has larger cells and lower Ki-67. The jaw location is characteristic of endemic (EBV-associated) Burkitt lymphoma.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.