#00063994

A 23-year-old male presented with a firm and painful lump in the submandibular area. He reported no B symptoms. FNA performed was suggestive of B-cell lymphoma with high-grade features. Subsequent excisional biopsy showed an enlarged lymph node with diffuse architectural effacement by abnormal, intermediate- to larger-sized lymphoid cells, with round to irregular nuclei, fine to dispersed chromatin, variably distinct small nucleoli, and scant amount of cytoplasm. Frequent apoptotic bodies and mitotic figures were seen. Numerous tingible-body macrophages (arrowhead) were present, impacting a Starry-sky appearance. By immunohistochemistry, the neoplastic lymphocytes expressed CD20, PAX-5, CD10 (very weak), and BCL-6 but were negative for BCL-2. C-MYC positivity was seen in <5% of cells. FISH studies revealed an abnormal signal pattern with 1R>=3G2A in 78% nuclei (normal <9.0%), indicative of gain of material at 11q23.3 and loss of material at 11q25. Rearrangement of MYC, BCL-2 or BCL6 were not detected. In summary, the morphologic and immunophenotypic findings in conjunction with cytogenetics/FISH studies supported the diagnosis of Burkitt-Like Lymphoma with 11q Aberration.

References:

1. Wagener R, Seufert J, Raimondi F, et al. The mutational landscape of Burkitt-like lymphoma with 11q aberration is distinct from that of Burkitt lymphoma. Blood 2019 Feb 28; 133(9);962-966.

2. Gonzalez-Farre B, Ramis-Zaldivar JE, Salmeron-Villalobos J, et al. Burkitt-like lymphoma with 11q aberration: a germinal center-derived lymphoma genetically unrelated to Burkitt lymphoma. Haematologica 2019 Sep;104(9):1822-1829.