This is a 33 year old female with mediastinal lymphadenopathy and a small bowel obstruction.  The excised lymph node and small bowel show “starry-sky” appearance due to many tingible-body macrophages on low power. On high power, atypical lymphocytes are seen characterized by a monomorphic population of intermediate-sized cells with variably prominent and sometimes multiple nucleoli, stippled chromatin pattern, and moderate to scant amounts of cytoplasm. These cells were positive for CD19 and c-myc and negative for CD10 and Bcl-2. Ki-67 was 100% consistent with the diagnosis of Burkitt lymphoma. Negativity for CD10 is an atypical feature of BL which is usually positive for this marker.