Burkitt lymphoma vs Diffuse large B-cell lymphoma
How to tell Burkitt lymphoma and Diffuse large B-cell lymphoma apart when a board question makes them look alike.
Burkitt is MYC/t(8;14), starry-sky, very fast; DLBCL is diffuse large B-cell sheets without the classic MYC-star pattern.
Side by side
Burkitt lymphoma is a highly aggressive MYC-driven B-cell lymphoma with t(8;14), starry-sky histology, very high Ki-67, and either a jaw mass in endemic disease or an abdominal/ileocecal mass in sporadic disease.
Diffuse large B-cell lymphoma is an aggressive lymphoma of large atypical B cells, often in older adults, with rapidly enlarging nodal or extranodal mass.
MYC overexpression drives rapid cell cycling, producing very high tumor turnover and starry-sky macrophage cleanup.
DLBCL arises from transformed mature B cells with heterogeneous genetic drivers and diffuse sheets of large malignant cells.
t(8;14) involving MYC and immunoglobulin heavy chain, CD10 positivity, high Ki-67, and starry-sky pattern support Burkitt lymphoma.
Sheets of large CD20-positive B cells with subtype-specific markers support DLBCL.
The trap
Both are aggressive B-cell lymphomas, so MYC translocation, age/location pattern, and histology separate them.
Watch it explained
The repair move
For aggressive B-cell lymphoma, look for MYC/starry-sky before calling every fast mass DLBCL.
Try a free question
CoreA child has a rapidly enlarging jaw mass. Biopsy shows a starry-sky pattern, nearly 100% proliferation index, CD10-positive B cells, and t(8;14) involving MYC. Which diagnosis is most likely?
Show answer and explanation
Answer: A. Burkitt lymphoma. MYC t(8;14) with starry-sky histology points to Burkitt lymphoma.
Why the other choices are tempting
- B. DLBCL has diffuse large B cells but lacks the classic MYC/starry-sky package.
- C. Follicular lymphoma has t(14;18) and BCL2 overexpression.
- D. Mantle cell lymphoma has t(11;14) and cyclin D1 overexpression.
- E. Hodgkin lymphoma has Reed-Sternberg cells.
Flashcards
Tap a card to flip it.
What translocation points to Burkitt lymphoma?
t(8;14) involving MYC and immunoglobulin heavy chain points to Burkitt lymphoma.
What histology points to Burkitt lymphoma?
Starry-sky histology points to Burkitt lymphoma.
Quick answers
What is the fastest way to tell Burkitt lymphoma from Diffuse large B-cell lymphoma?
Burkitt is MYC/t(8;14), starry-sky, very fast; DLBCL is diffuse large B-cell sheets without the classic MYC-star pattern.
What is the key clue for Burkitt lymphoma?
Burkitt lymphoma is a highly aggressive MYC-driven B-cell lymphoma with t(8;14), starry-sky histology, very high Ki-67, and either a jaw mass in endemic disease or an abdominal/ileocecal mass in sporadic disease.
What is the key clue for Diffuse large B-cell lymphoma?
Diffuse large B-cell lymphoma is an aggressive lymphoma of large atypical B cells, often in older adults, with rapidly enlarging nodal or extranodal mass.
What is the common trap with Burkitt lymphoma vs Diffuse large B-cell lymphoma?
Both are aggressive B-cell lymphomas, so MYC translocation, age/location pattern, and histology separate them.