Abstract :
Introduction: Burkitt lymphoma is an aggressive type B-cell NHL. It is an infrequently occurring
aggressive B-cell NHL, which occurs in children and young adults and it is probably the fastest growing
tumor in humans, with exuberant proliferation. However, it is now one of the most curable conditions in
the developed world.
Objective: The aim of this study to analyze the clinico-pathologic, immunophenotypic, cytogenetic and
molecular pathology of cases diagnosed as Burkitt lymphoma/leukemia.
Materials and Methods: All cases diagnosed as Burkitt lymphoma/leukemia (BL) between2008 and 2016
were included in this study. All the relevant data was collected from Pathology and Oncology records.
Peripheral blood, bone marrow smears and histopathology slides were reviewed. Stains like Giemsa,
Oil -Red-O and Hematoxylin and Eosin (H&E) were reviewed. Immunohistochemistry with lymphoma
markers were done on tissue sections. Immunophenotyping on marrow aspirates was done with 4-color
flowcytometry. Flourescence In-situ Hybridization (FISH) assay was performed on some bone marrow
aspirate samples.
Results: During this study period, 37 cases were diagnosed as Burkitt leukemia / Lymphoma.
There were25 male and 12 female (M: F: 2.2:1). Ten patients had hepatosplenomegaly and 8 had
lymphadenopathy. B-type symptoms in 21 patients and raised LDH levels in 17 cases were observed.
There were 25 patients diagnosed on bone marrow studies (21 fresh cases and 4 cases of relapse). Twelve
patients were diagnosed as high grade NHL on histopathological examination (HPE). Flow analysis was
done in 6 cases, which were positive for CD10, CD19, and CD20. Immuno histochemistry on biopsy
specimens was done in 12 cases and 3 trephine biopsy sections were positive for B-cell lymphoma markers
with high Ki67. FISH analysis was performed on 5 specimens and showed c -MYC rearrangement and t
(8-14) translocation
Conclusion: Burkitt lymphoma/leukemia is an aggressive variant of B cell NHL. It has classical
morphology with monomorphic large lymphoid cells with prominent punched out vacuoles, positive for
lipid vacuoles. Even with aggressive chemotherapy, seven cases were in remission and majority patients
expired. As per our knowledge this is the largest case series from India.
Keyword :
Burkitt lymphoma, Starry-sky appearance, Bone marrow, Flow cytometry, Immunohistochemistry.