A 25-year-old presents with jaw swelling, and biopsy shows a 'starry sky' pattern with monotonous intermediate-sized lymphoid cells, frequent mitoses, and a Ki-67 of nearly 100%. The translocation most likely involves:

• A t(14;18) involving BCL2
• B t(11;14) involving BCL1 (cyclin D1)
• C t(2;5) involving ALK
• D t(8;14) involving MYC ✓

Explanation

Burkitt lymphoma characteristically shows a starry sky pattern (tingible-body macrophages), near 100% Ki-67 proliferation index, and t(8;14)(q24;q32), which juxtaposes MYC with the immunoglobulin heavy chain gene, leading to constitutive MYC overexpression. t(14;18) is follicular lymphoma. t(11;14) is mantle cell lymphoma. t(2;5) is anaplastic large cell 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.