Details
42-year old female with rapid onset ascites and a right ovarian mass. Flow cytometry shows the cells to be CD20+ and CD10+ with kappa light chain restriction. Immunohistochemistry on a concurrent tissue biopsy shows the abnormal cells to be negative for BCL-2 and MIB-1 100%.
Burkitt lymphoma is a fast-growing leukemia in which too many B lymphocytes form in the blood and bone marrow. It may start in the lymph nodes or it may start in the blood and bone marrow without lymph node involvement.
In this case, the clinical history, especially including the flow cytometric findings, are consistent with the diagnosis of Burkitt lymphoma. The high MIB-1 count, and BCL2 negativity are relatively classic. Morphologically, the smear shows monomorphic cells with intracellular lipid vacuoles — another classic finding in Burkitt lymphoma. This is related to altered lipid metabolism.
This diagnosis is considered "critical", and a phone call to the submitting clinician would be warranted.
See related content for links to other examples of this entity.