7a

Burkitt lymphoma

·         Occurs mostly in children / HIV infected pateients ·         Endemic in Africa – but occurs worldwide ·         MYC – 8;14 ·         EBV: seen in most endemic cases ·         Usually extranodal – jaw (endemic), abdominal (sporadic) à leukemic ·         Diffuse proliferation of uniform intermediate size B lymphocytes with fine chromatin, small nucleoli, extremely numerous mitoses ·         Starry sky: histiocytes ·         Very aggressive if not treated: highly curable – except in HIV ·         Note: in malaria belt:  burkitt, large B –cell type, primary effusion type lymphomas

What do you see?

·          “starry sky”: diffuse uniform B cell background (sky); tingible body macrophages (stars)

·          ↑ mitosis

·          Medium sized B cells: small nucleoli, fine chromatin

·          Aspirate: note lipid vacuoles in cytoplasm

What type of lymphoma is this? Burkittlymphoma

What virus is associated with this type of lymphoma? Is it more prominent in a specific subtype?

·          EBV: most endemic cases – also seen in sporadic and immunodeficiency type (HIV+)

What translocation is associated with this type of lymphoma? Myc (8;14)

Where is the endemic form typically found? What extranodal site is it associated with?

·         Endemic: malaria belt Africa – jaw/ facial bones

·         Sporadic typically involves GI

Is this an aggressive tumor? What is the prognosis?

·         Very aggressive!! Typically responds well to Rx but has a poor Px in immunodeficient patients