Primary gastric Burkitt's lymphoma: a clinicopathological analysis of four cases / 临床与实验病理学杂志

ABSTRACT

Purpose To investigate the clinicopathological features,diagnosis,treatment and prognosis of primary gastric Burkitt's lymphoma. Methods The clinical and pathological features were retrospectively analyzed in 4 case of primary gastric Burkitt's lymphoma. The endoscopic features,immunophenotype and molecular pathology were also analyzed and discussed with review of the literatures. Results Primary gastric Burkitt' s lymphoma mainly occurred in children,with an average age of 8 years (3～15 years) . Endoscopic findings were tuberous protuberance with surface ulcers (3 cases) . The diffuse distribution of atypical lymphoid cells with"starry sky"phenomenon in gastric mucosa was observed under microscope,the cells were of medium size and single shape,the nucleus was round or oval and the shape was uniform,the chromatin was thicker,and there were several small nucleoli,the cytoplasm was rare and slightly basophilic,and the nuclear mitosis was more frequently noted. Immunophenotyping showed that both CD20 and CD79a were all strongly positive,and the Ki-67 proliferative index was higher than 95％. The positive intensity of CD10 and BCL-6 varied from one to another. MUM1 and CD3 were all negative. One case was positive for EBER (in situ hybridization) . Meanwhile, all of these cases showed MYC gene breakage,one of them was detected by IGH/BCL-2 fusion gene but no fusion was found. Conclusion Primary gastric Burkitt's lymphoma is rare. Its endoscopic features,histomorphology,immunophenotype and molecular pathology are relatively typical and it is mainly distinguished from high-grade B cell lymphoma,lymphoblastic lymphoma and myeloid sarcoma. Burkitt's lymphoma is a highly malignant tumor,but the current treatment is relatively mature. Early diagnosis and early treatment can significantly improve the prognosis of these patients.