A 30-year-old presents with a jaw mass, elevated LDH, and rapidly enlarging abdominal lymph nodes. Biopsy shows intermediate-sized lymphocytes with multiple small nucleoli, numerous mitoses, and a 'starry sky' pattern. The translocation most likely driving this lymphoma is:
- A t(14;18) — BCL2 overexpression
- B t(11;14) — Cyclin D1 overexpression
- C t(8;14) — MYC overexpression ✓
- D t(2;5) — ALK-NPM fusion
Correct answer: C. t(8;14) — MYC overexpression
Explanation
Burkitt lymphoma shows the t(8;14) translocation placing MYC under the IGH enhancer, causing massive MYC-driven proliferation. The 'starry sky' pattern reflects tingible-body macrophages engulfing apoptotic tumor cells. 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.