Burkitt lymphoma overview

Burkitt lymphoma (BL) is a highly aggressive B cell neoplasm that can present in one of three distinct clinical forms: endemic, sporadic, and immunodeficiency-associated.
Starry sky: The benign histiocytes ("the stars") are large with abundant, clear cytoplasm and are dispersed relatively evenly throughout a background of basophilic tumor cells ("the sky").
There is an extremely high rate of proliferation, as well as a high rate of apoptotic cell death as evidenced by a Ki-67+ (MIB-1+) cells fraction approaching 100 percent and a "starry-sky" pattern.
BL cells express surface IgM and B cell-associated antigens (CD19, CD20, CD22, CD79a), as well as CD10, HLA-DR, and CD43. They lack CD5, BCL-2, TdT, and typically lack CD23.
BL tumor cells are monomorphic, medium-sized cells with round nuclei, multiple nucleoli, and basophilic cytoplasm. Prominent cytoplasmic lipid vacuoles are usually evident on imprints or smears.
BL is strongly (but not uniformly) associated with a translocation between the long arm of chromosome 8, the site of the MYC oncogene (8q24), and one of three locations on Ig genes: t(8;14), t(2;8), or t(8;22).