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
