Pediatric B-Cell Lymphoma With Lymphoblastic Morphology, TdT Expression,<i>MYC</i>Rearrangement, and Features Overlapping With Burkitt Lymphoma

Meznarich, Jessica; Miles, Rodney R.; Paxton, Christian N.; Afify, Zeinab

doi:10.1002/pbc.25907

Cited by 7 publications

(2 citation statements)

References 15 publications

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“…In addition, cytoplasmic and nuclear vacuoles presented more frequently in BL than other lymphomas. Rare cases of B‐ALL/LBL with Burkitt‐like morphology and IGH/MYC rearrangement were reported . However, these cases had immature lymphoid immunophenotypes including expression of TdT, absence of BCL6, and dim‐to negative CD45 …”

Section: Discussionmentioning

confidence: 99%

The accuracy of diagnosing Burkitt lymphoma in serous effusion specimen: A cytological‐histological correlation with ancillary studies

Zhang

Zhao

et al. 2019

Cytopathology

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Burkitt lymphoma (BL) is an entity of highly aggressive non-Hodgkin lymphoma (NHL) rarely presenting as serous effusion (SE). 1 Given its significant overlaps with reactive lymphocytes, mesenchymal neoplasm and other subtypes of lymphomas, it is really a challenge to diagnose BL by using SE specimen. To date, only a few case reports of malignant SE caused by BL have been published. 2-5 However, the cytological features of BL in SE have not been well described due to the small sample sizes of these Abstract Objective: The objective of this study is to evaluate the effectiveness of diagnosing Burkitt lymphoma (BL) in serous effusion (SE) specimen and summarise the characteristics of BL in SE. We also assess the utility of a germinal centre-associated marker, LMO2, in the differential diagnosis of BL in SE specimens.Methods: Eleven cases of malignant SE caused by BL were reviewed. SE cytology and histological biopsy diagnoses were compared to determine the concordance rates. Results:A uniform population of non-cohesive medium-sized lymphoid cells with frequent apoptosis was found on SE smears or cell block sections. Cytoplasmic and nuclear vacuoles presented in seven cases. Immunophenotyping demonstrated positivity for CD79a (three of three cases), CD10 (seven of 11 cases), BCL6 (nine of 11 cases), MUM-1 (one of nine cases), CD20 and MYC (11 cases). LOM2 was negative in nine of nine cases. Both IGH/MYC rearrangement and MYC rearrangement were identified in four of six cases, and two of six cases carried isolated MYC rearrangement or isolated IGH/MYC rearrangement, respectively. The diagnoses of eight BLs and three B-cell non-Hodgkin lymphomas were established according to cytomorphology and ancillary studies. SE cytology provided initial pathological diagnoses for eight cases (six BLs and two non-Hodgkin lymphomas). Histodiagnoses were available for eight cases. The concordance rate of cytological-histological diagnosis was 62.5% (five of eight cases). Conclusions:Combining cytomorphology and ancillary studies enables the accurate diagnosis of BL in SE specimens. Furthermore, LMO2 may be a useful marker in the differential diagnosis of BL. K E Y W O R D Sancillary studies, Burkitt lymphoma, cytopathology, LMO2, serous effusion

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Section: Discussionmentioning

confidence: 99%

The accuracy of diagnosing Burkitt lymphoma in serous effusion specimen: A cytological‐histological correlation with ancillary studies

Zhang

Zhao

et al. 2019

Cytopathology

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“…Much less commonly, IG-MYC rearrangements (IG-MYC-r) have been identified in lymphoid malignancies expressing a surface immunoglobulin (sIg) negative, immature B-cell precursor (BCP) immunophenotype [6][7][8][9][10][11][12][13] . Several recent acute lymphoblastic leukaemia (ALL) clinical trials have excluded these patients to avoid the risk of mistreating mature B-NHL.…”

Section: Data Availabilitymentioning

confidence: 99%

Molecular characterization and clinical outcome of B-cell precursor acute lymphoblastic leukemia with IG-MYC rearrangement

et al. 2022

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Rarely, immunophenotypically immature B-cell precursor acute lymphoblastic leukemia (BCP-ALL) carries an immunoglobulin- MYC rearrangement (IG-MYC-r). This can result in diagnostic confusion with Burkitt lymphoma/leukemia and use of individualized treatment schedules of unproven efficacy. Here we compare the molecular characteristics of these conditions and investigate historic clinical outcome data. We identified 90 cases registered in a national BCP-ALL clinical trial/registry. When present, diagnostic material underwent cytogenetic, exome, methylome and transcriptome analyses. The outcomes analyzed were 3-year event-free survival and overall survival. IG-MYC-r was identified in diverse cytogenetic backgrounds, co-existing with either established BCP-ALL-specific abnormalities (high hyperdiploidy, n=3; KMT2A-rearrangement, n=6; iAMP21, n=1; BCR-ABL1, n=1); BCL2/BCL6-rearrangements (n=15); or, most commonly, as the only defining feature (n=64). Within this final group, precursor-like V(D)J breakpoints predominated (8/9) and KRAS mutations were common (5/11). DNA methylation identified a cluster of V(D)J-rearranged cases, clearly distinct from Burkitt leukemia/lymphoma. Children with IG-MYC-r within that subgroup had a 3-year event-free survival of 47% and overall survival of 60%, representing a high-risk BCP-ALL. To develop effective management strategies this group of patients must be allowed access to contemporary, minimal residual disease-adapted, prospective clinical trial protocols.

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Treatment and outcome of IG-MYC+ neoplasms with precursor B-cell phenotype in childhood and adolescence

et al. 2019

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Pediatric B-Cell Lymphoma With Lymphoblastic Morphology, TdT Expression,MYCRearrangement, and Features Overlapping With Burkitt Lymphoma

Cited by 7 publications

References 15 publications

The accuracy of diagnosing Burkitt lymphoma in serous effusion specimen: A cytological‐histological correlation with ancillary studies

The accuracy of diagnosing Burkitt lymphoma in serous effusion specimen: A cytological‐histological correlation with ancillary studies

Molecular characterization and clinical outcome of B-cell precursor acute lymphoblastic leukemia with IG-MYC rearrangement

Treatment and outcome of IG-MYC+ neoplasms with precursor B-cell phenotype in childhood and adolescence

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