A 5-year-old boy presents with a rapidly enlarging mass of the maxilla and jaw. Biopsy shows sheets of intermediate sized lymphoid cells with round nuclei, multiple small nucleoli, and abundant apoptosis, interspersed with pale tingible body macrophages. Immunophenotype shows surface IgM, CD10, and BCL6 positivity. Which cytogenetic abnormality is expected?
- A t(14;18) involving BCL2 and IGH
- B t(11;18) involving API2 and MALT1
- C t(8;14) involving MYC and IGH ✓
- D t(15;17) involving PML and RARA
Correct answer: C. t(8;14) involving MYC and IGH
Explanation
The starry sky pattern created by benign macrophages engulfing apoptotic tumor cells, together with germinal center markers CD10 and BCL6 and surface IgM, identifies Burkitt lymphoma. Overexpression of MYC from translocation to an immunoglobulin heavy chain locus, classically t(8;14), drives the extremely high proliferation rate. t(14;18) defines follicular lymphoma through BCL2, t(11;18) defines extranodal marginal zone lymphoma, and t(15;17) defines acute promyelocytic leukemia.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.