Burkitt lymphoma t(8;14) juxtaposes MYC with the immunoglobulin heavy chain locus, causing constitutive MYC overexpression. Which feature on biopsy is most characteristic of Burkitt lymphoma?
- A Starry sky pattern caused by tingible body macrophages interspersed among uniform lymphoblasts ✓
- B Nodular growth pattern with follicle center cells and BCL2 overexpression
- C Reed-Sternberg cells with lacunar variants in a fibrotic background
- D Anaplastic large cells with hallmark cells and ALK expression
Correct answer: A. Starry sky pattern caused by tingible body macrophages interspersed among uniform lymphoblasts
Explanation
Burkitt lymphoma shows a characteristic 'starry sky' pattern on low-power microscopy: tingible body macrophages (containing apoptotic debris, appearing pale) are scattered among sheets of uniform, medium-sized lymphoblasts (dark cells), creating the sky-and-stars appearance. The extremely high proliferation fraction (Ki-67 nearly 100%) reflects MYC-driven cell cycle activation. BCL2 overexpression is absent, unlike follicular lymphoma.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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