Surgical Pathology Criteria

Burkitt Lymphoma

Differential Diagnosis

Burkitt Lymphoma Lymphoblastic Lymphoma, T and B
Median age 30 years Median age 17-20 years
B lineage markers positive 90% T, 10% B
Multiple nucleoli Inconspicuous nucleoli
Coarse chromatin Fine chromatin
Thin rim of cytoplasm Scant cytoplasm
Frequently GI or ovary T frequently mediastinal, B frequently cutaneous
TdT negative TdT virtually always positive
Translocation involving myc gene No myc translocation
Both have extremely high mitotic rates and starry sky macrophages although Burkitt lymphoma typically has a higher mitotic rate and the starry sky pattern is more uniform

Burkitt Lymphoma Blastic Mantle Cell Lymphoma
Median age 30 years Rare under 30 years
Histiocytes infrequent (tingible body macrophages frequent) Scattered histiocytes in most cases
No prior diagnosis of mantle zone lymphoma May have prior diagnosis of mantle zone lymphoma
bcl1 negative bcl1 100%
CD5 negative CD5 80%
CD10 99% CD10 negative
Translocation involving myc gene No myc translocation

Burkitt Lymphoma Diffuse Large B Cell Lymphoma
Starry sky macrophages present Starry sky pattern infrequent
Fine chromatin Vesicular chromatin
Multiple small nucleoli Few, prominent nucleoli
Uniform cells Heterogeneous cells
Ki67 nearly 100% Ki67 moderately high
Translocation involving myc gene 15% of cases have myc translocation
Generally only a problem if cytologic detail is obscured by processing related artifacts

Burkitt Lymphoma Prolymphocytic SLL/CLL
Starry sky macrophages present Starry sky macrophages variable
Uniform population Admixed prolymphocytes and small cells
Cytoplasm amphophilic or basophilic Cytoplasm pale
Multiple nucleoli Single nucleolus
Ki67 nearly 100% Ki67 moderately high
CD23 negative CD23 85%
Translocation involving myc gene No myc translocation

Stanford Medicine Resources:

Footer Links: