Burkitt's lymphoma pathophysiology

Jump to navigation Jump to search

Burkitt's lymphoma Microchapters


Patient Information


Historical Perspective




Differentiating Burkitt's lymphoma from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


Diagnostic Study Of Choice


History and Symptoms

Physical Examination

Laboratory Findings

X Ray Findings




Other Imaging Studies

Other Diagnostic Studies


Medical Therapy


Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Burkitt's lymphoma pathophysiology On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides


American Roentgen Ray Society Images of Burkitt's lymphoma pathophysiology

All Images
Echo & Ultrasound
CT Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Burkitt's lymphoma pathophysiology

CDC on Burkitt's lymphoma pathophysiology

Burkitt's lymphoma pathophysiology in the news

Blogs on Burkitt's lymphoma pathophysiology

Directions to Hospitals Treating Burkitt's lymphoma

Risk calculators and risk factors for Burkitt's lymphoma pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Shivali Marketkar, M.B.B.S. [2] Sowminya Arikapudi, M.B,B.S. [3], Kamal Akbar, M.D.[4]


The c-myc gene is involved in the pathogenesis of Burkitt's lymphoma. On gross pathology, ulceration and discharge are characteristic findings of Burkitt's lymphoma. On microscopic histopathological analysis, "starry sky" appearance is a characteristic finding of Burkitt's lymphoma.


Burkitt's lymphoma is an aggressive and rapidly growing tumor.[1]. It can present in a wide variety of locations which include:


Translocation of chromosome 8 myc locus with 3 possible partners (accounting for 90% of translocations):[2]

  • The Ig heavy chain region on chromosome 14: t(8;14)
  • The kappa light chain locus on chromosome 2: t(2;8)
  • The lambda light chain locus on chromosome 22: t(8;22)
  • WHO committees suggest the following:
  • If morphologic features are intermediate, diagnosis of Burkitt's should only be made if the Ki-67 fraction of viable cells is at least 99 percent
  • If morphologic features suggest diffuse large B cell lymphoma, but have with a high proliferation fraction or t(8;14), they should be classified as diffuse large B cell lymphoma

Gene targets

  • Unique genetic alterations promote cell survival in Burkitt's lymphoma, distinct from other types of lymphoma[3]
  • These TCF3 and ID3 gene mutations in Burkitt's correspond to a cell survival pathway that may be found to be amenable to targeted therapy.[4]

MicroRNA expression

  • In 2014, it was described that short non-coding RNAs named microRNAs (miRNAs) have important functions in lymphoma biology
  • In malignant B cells miRNAs participate in pathways fundamental to B cell development like B cell receptor (BCR) signaling, B cell migration/adhesion, cell-cell interactions in immune niches, and the production and class-switching of immunoglobulins[5]
  • MiRNAs influences B cells in the following manner:[5]
    • Maturation
    • Generation of marginal zone
    • Follicular
    • Plasma
    • Memory B cells


The tumor cells in Burkitt lymphoma generally strongly express markers of B cell differentiation and they are the following:[6]

  • (CD19
  • CD20
  • CD22)
  • CD10
  • BCL6
  • The tumor cells are generally negative for BCL2 and TdT. The high mitotic activity of Burkitt's lymphoma is confirmed by nearly 100% of the cells staining positive for Ki67.[7]

Malignant B cell characteristics

Malignant B cells have identical DNA recombinations of the V(D)J region of the immunoglobin genes and there characteristics are the following: [8]

  • This means that no increase in specificity of antibody molecules is occurring in the malignant cells
  • These malignant cells are thus clonal populations and can be assayed for by using DNA probes specific for the regions where recombination is expected
  • Normal DNA will be characterized by two high concentration of identical germ line DNA V(D)J regions and endless, likely undetectable, non-germline Ig V(D)J DNA
  • Lymphoma cells have an additional high concentration of V(D)J DNA that is unlike the germ line, indicating clonal populations of B Cells that are not undifferentiated B cells (germ line DNA cells)
  • Assays typically use the process of electrophoresis and southern blot analysis to determine the existence of these characteristics

Gross Pathology

Microscopic Pathology

On microscopic histopathological analysis, characteristic findings of Burkitt's lymphoma include:[10]

  • Medium-sized (~1.5-2x the size of a RBC) with uniform size ("monotonous") -- key feature (i.e. tumor nuclei size similar to that of histiocytes or endothelial cells)
  • Round nucleus
  • Small nucleoli
  • Relatively abundant cytoplasm (basophilic)
  • Brisk mitotic rate and apoptotic activity
  • Cellular outline usually appears squared off
  • "Starry-sky pattern":
  • The stars in the pattern are tingible-body macrophages (macrophages containing apoptotic tumor cells)
  • The tumour cells are the sky




  1. Burkitt lymphoma. Radiopedia. http://radiopaedia.org/articles/burkitt-lymphoma Accessed on October,5 2015
  2. Burkitt's Lymphoma. Wikibooks. https://en.wikibooks.org/wiki/Radiation_Oncology/NHL/Burkitt_lymphoma#Pathology Accessed on October,5 2015
  3. "NIH study shows Burkitt lymphoma is molecularly distinct from other lymphomas". National Cancer Institute.
  4. Staudt L, et al. Burkitt Lymphoma Pathogenesis and Therapeutic Targets from Structural and Functional Genomics. Nature. August 12, 2012 doi:10.1038/nature11378
  5. 5.0 5.1 Musilova, K; Mraz, M (2014). "MicroRNAs in B cell lymphomas: How a complex biology gets more complex". Leukemia. doi:10.1038/leu.2014.351. PMID 25541152.
  6. Chuang, Shih-Sung; Ye, Hongtao; Du, Ming-Qing; Lu, Chin-Li; Dogan, Ahmet; Hsieh, Pin-Pen; Huang, Wan-Ting; Jung, Yun-Chih (2007). "Histopathology and Immunohistochemistry in Distinguishing Burkitt Lymphoma From Diffuse Large B-Cell Lymphoma With Very High Proliferation Index and With or Without a Starry-Sky Pattern". American Journal of Clinical Pathology. 128 (4): 558–564. doi:10.1309/EQJR3D3V0CCQGP04. ISSN 0002-9173.
  7. Steven H Swerdlow (2008). WHO classification of tumours of haematopoietic and lymphoid tissues. World Health Organization classification of tumours. Lyon, France : International Agency for Research on Cancer. ISBN 978-92-832-2431-0.
  8. Ferry, J. A. (2006). "Burkitt's Lymphoma: Clinicopathologic Features and Differential Diagnosis". The Oncologist. 11 (4): 375–383. doi:10.1634/theoncologist.11-4-375. ISSN 1083-7159.
  9. 9.0 9.1 Burkitt's lymphoma. Wikipedia. https://en.wikipedia.org/wiki/Burkitt%27s_lymphomaAccessed on October 5, 2015
  10. Bellan C, Lazzi S, De Falco G, Nyongo A, Giordano A, Leoncini L (2003). "Burkitt's lymphoma: new insights into molecular pathogenesis". J. Clin. Pathol. 56 (3): 188–92. PMC 1769902. PMID 12610094. Unknown parameter |month= ignored (help)

Template:Chromosomal abnormalities

Template:WikiDoc Sources