Entity | Histology | Immunophenotype | Genetic features/other |
Burkitt lymphoma | Monomorphic, medium-sized cells with round nuclei, multiple nucleoli, basophilic cytoplasm, prominent cytoplasmic lipid vacuoles, and a "starry-sky" pattern. Ki-67+ fraction approaching 100 percent. | Express surface IgM and B-cell-associated antigens (CD19, CD20, CD22, CD79a), as well as CD10, HLA-DR, and CD43. They lack CD5, bcl-2, and typically lack CD23. | Strongly (but not uniformly) associated with a translocation between the long arm of chromosome 8, the site of the c-MYC oncogene (8q24), and one of three locations on Ig genes: t(8;14), t(2;8), or t(8;22). No evidence of t(14;18). |
Diffuse large B-cell lymphoma | Large, transformed B-cells with prominent nucleoli and basophilic cytoplasm, a diffuse growth pattern and a high proliferation (Ki-67+) fraction. | Generally express pan B-cell antigens (CD19, CD20, CD22, CD79a). | The majority has genetic abnormalities, but there is no single cytogenetic change that is typical or diagnostic. A subset will have c-MYC rearrangements. |
Precursor T-cell lymphoblastic leukemia/lymphoma | Varied morphology, but may resemble Burkitt lymphoma but have intermediate sized oval or round nuclei, more dispersed chromatin, several distinct nuclei, and more abundant cytoplasm. | Express TdT and are of T-cell phenotype typically positive for CD7 and either surface or cytoplasmic CD3, and variably express CD2, CD5, CD1a, CD4 and/or CD8. | No single cytogenetic change is typical or diagnostic. |
Precursor B-cell lymphoblastic leukemia/lymphoma | Varied morphology, but may resemble Burkitt lymphoma but have intermediate sized oval or round nuclei, more dispersed chromatin, several distinct nuclei, and more abundant cytoplasm. | Lack expression of surface immunoglobulin. Express TdT and variably express the B-cell markers CD19, CD22, CD20, and CD79a, leukocyte common antigen CD45 and common acute lymphoblastic leukemia antigen CD10 (CALLA). | No single cytogenetic change is typical or diagnostic. May have either or both immunoglobulin heavy chain and T-cell receptor gamma or beta chain gene rearrangements, or may lack rearrangements. |
Mantle cell lymphoma, blastoid variant | Intermediate-sized cells with dispersed chromatin, irregular nuclear contours, and scant cytoplasm with a high mitotic rate. | Express high levels of surface IgM and IgD and express pan-B cell antigens (CD19, CD20), CD5, and FMC7. Rare cases lack CD5 or express CD23. Nuclear staining for cyclin D1 present in 95 percent of cases. | Not seen in children. Strongly associated with t(11;14)(q13;q32). |
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