Comprehensive morphological diagnosis of Burkitt’s lymphoma

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Objective: to determine opportunities for the comprehensive morphological diagnosis (routine cytology and histology, immunocytochemistry and immunohistochemistry, molecular genetic tests) of Burkitt’s lymphoma (BL). Subjects and methods. The investigation enrolled 19 patients in whom morphological (cytological and histological), immunomorphological (immunocytochemical (ICH) and immunohistochemical (IHC)) and molecular genetic studies could diagnose BL that is B-cell lymphoma with the expression of Ki-67 protein having a proliferative activity of 95 to 100%. The differential diagnosis of BL was carried out in 6 patients with diffuse large B-cell lymphoma (DLBCL) having a high proliferative activity of 80 to 100%. The diagnoses of BL and DLBCL were immunohistochemically confirmed in all cases. In addition, ICH using Dako’s EnVision FLEX visualization and monoclonal antibodies was performed for immunophenotyping. A panel of antibodies included leukocyte common antigen, total cytokeratins, CD19, CD20, CD79a, CD10, Bcl2, Bcl6, CD23, CD34, TdT, CD3, CD4, CD5, CD8, CyclinD1, EBV, and Ki-67. The DAKO antibodies labelled with a fluorescent dye (FITC or RPE): CD45, CD19, CD20, CD79a, CD10, Bcl2, Bcl6, CD23, CD34, TdT, κ, λ, CD3, CD4, CD5, CD8, and Ki67 were employed using the flow cytofluorometric technique (by means of a FACSCalibur flow cytofluorometer (Becton Dickinson Co., USA) for immunophenotyping. Rearrangements of the c-MYC gene were determined by fluorescence in situ hybridization (FISH) using a locus-specific MYC FISH DNA Probe, Split Signal, to detect any rearrangements in the c-MYC gene. Results. The accuracy of routine cytological examination for suspected BL was 88%, its sensitivity and specificity were 89 and 100%, respectively. The accuracy of immunophenotyping, which made it possible to only assume BL, was 92%; its sensitivity and specificity were 100 and 67%, respectively. The accuracy, sensitivity and specificity of a comprehensive study (histology and cytology, IHC, ISH, and FISH) in diagnosing BL were 100%. Conclusion. The final diagnosis of BL should be based on integrated histological, cytological, IHC, cytochemical, and molecular genetic findings.

Keywords:

Burkitt’s lymphoma

histology

cytology

immunohistochemistry

immunocytochemistry

flow cytofluorometry

in situ hybridization technique

Authors:

Slavnova E.N.

FGBU "Moskovskiĭ nauchno-issledovatel'skiĭ onkologicheskiĭ institut im. P.A. Gertsena" Minzdrava Rossii

Kaplanskaya I.B.

P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia, Moscow, Russia

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