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IMAGE IN HEMATOLOGY
Year : 2017  |  Volume : 8  |  Issue : 3  |  Page : 125

Peripheral blood findings to initial burkitt lymphoma diagnosis


Department of Pharmacy and Clinical Laboratory, Clinical Laboratory Division, University Hospital, University of São Paulo, Sao Paulo, Brazil

Date of Web Publication18-Sep-2017

Correspondence Address:
Ricardo Ambrósio Fock
Department of Pharmacy and Clinical Laboratory, Clinical Laboratory Division, University Hospital, University of São Paulo, Avenida Lineu Prestes, 2565, Sao Paulo
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joah.joah_43_17

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How to cite this article:
de Noronha TR, Fock RA. Peripheral blood findings to initial burkitt lymphoma diagnosis. J Appl Hematol 2017;8:125

How to cite this URL:
de Noronha TR, Fock RA. Peripheral blood findings to initial burkitt lymphoma diagnosis. J Appl Hematol [serial online] 2017 [cited 2019 Dec 14];8:125. Available from: http://www.jahjournal.org/text.asp?2017/8/3/125/215000



A 19-year-old female patient sought medical attention complaining of lumbar pain for 18 days. On physical examination, it was identified as cervical lymphadenopathy. Hemogram showed red blood cell of 4,340,000/μL, Hb 12.3 g/dL, platelets 148,000/μL, and white blood cell of 13,090/μL with 65% neutrophils, 2% eosinophils, 1% basophils, 3% monocytes, 22% lymphocytes, and 7% of medium-sized cells, cytoplasm deeply basophilic with vacuoles (starry sky), and medium-high nucleus/cytoplasm relationship [Figure 1]. The imaging tests showed an atypical mass infiltration in the pancreas and in the left paravertebral region, and the diagnosis of Burkitt lymphoma (BL) was confirmed on biopsy of the submandibular region using immunohistochemistry that shows the following positive markers: CD20, CD10, B-cell lymphoma 2 (BCL2), Ki67, PAX5, and BCL6.[1],[2]

BL, first described by Denis Burkitt in 1958, is an aggressive subtype of BCL with an extremely short doubling time that often presents in extranodal sites or as an acute leukemia.[1] Early diagnosis and treatment are critical before life-threatening complications, such as airway compromise or spinal cord compression, set in. Knowledge about peripheral blood morphology features assists in detection and provides rapid treatment. For young adults with BL, standard regimens such as CODOX-M/IVAC, although toxic, are tolerated, and outcomes are generally excellent.[1]
Figure 1 (a-d): Medium-sized cells, cytoplasm deeply basophilic with vacuoles (starry sky), and medium-high nucleus/cytoplasm relationship (May-Grünwald stain ×1000)

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  References Top

1.
Dunleavy K, Little RF, Wilson WH. Update on burkitt lymphoma. Hematol Oncol Clin North Am 2016;30:1333-43.  Back to cited text no. 1
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2.
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC; 2008.  Back to cited text no. 2
    


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