A 30-year-old HIV-positive man develops a rapidly enlarging jaw mass. Biopsy shows a 'starry sky' pattern with intermediate-sized lymphocytes showing high mitotic rate and Ki-67 near 100%. Cytogenetics reveals t(8;14). The oncogene dysregulated by this translocation is:

• A BCL2
• B BCL6
• C CYCLIN D1
• D MYC ✓

Explanation

Burkitt lymphoma is characterised by t(8;14)(q24;q32), which juxtaposes the MYC oncogene on chromosome 8 with the immunoglobulin heavy chain locus on chromosome 14, causing constitutive MYC overexpression that drives rapid cell proliferation. The near-100% Ki-67 proliferation index and 'starry sky' pattern (macrophages ingesting apoptotic tumour cells) are classic. BCL2 is associated with follicular lymphoma t(14;18); cyclin D1 with mantle cell lymphoma t(11;14).

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.