A 9-year-old boy presents with a rapidly enlarging jaw mass. Biopsy shows a sheet of medium-sized lymphoid cells with round nuclei, dispersed chromatin, multiple small nucleoli, and a very high mitotic rate. The background contains scattered macrophages with phagocytosed apoptotic debris, imparting a 'starry sky' appearance. Immunophenotyping shows CD10+, CD20+, BCL-2−, and 100% Ki-67 positivity. Which chromosomal translocation is MOST characteristic of this tumor?
- A t(14;18) — BCL2/IGH
- B t(8;14) — MYC/IGH ✓
- C t(11;14) — CCND1/IGH
- D t(2;5) — NPM1/ALK
Correct answer: B. t(8;14) — MYC/IGH
Explanation
The description is classic for Burkitt lymphoma: jaw mass in a child, starry-sky pattern, very high proliferation (Ki-67 ~100%), CD10+/CD20+, and BCL-2 negative. The hallmark translocation t(8;14) juxtaposes the MYC oncogene on chromosome 8 with the immunoglobulin heavy chain locus on chromosome 14, leading to constitutive MYC overexpression. t(14;18) characterizes follicular lymphoma; t(11;14) characterizes mantle cell lymphoma; t(2;5) characterizes 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.