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Diagnosis of Burkitt lymphoma using an algorithmic approach – applicable in both resource‐poor and resource‐rich countries
Author(s) -
Naresh Kikkeri N.,
Ibrahim Hazem A. H.,
Lazzi Stefano,
Rince Patricia,
Onorati Monica,
Ambrosio Maria R.,
BilhouNabera Chrystèle,
Amen Furrat,
Reid Alistair,
Mawanda Michael,
Calbi Valeria,
Ogwang Martin,
Rogena Emily,
Byakika Bessie,
Sayed Shahin,
Moshi Emma,
Mwakigonja Amos,
Raphael Martine,
Magrath Ian,
Leoncini Lorenzo
Publication year - 2011
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2011.08771.x
Subject(s) - bcl6 , lymphoma , burkitt's lymphoma , concordance , diffuse large b cell lymphoma , immunohistochemistry , fluorescence in situ hybridization , medicine , b cell lymphoma , pathology , cancer research , oncology , b cell , antibody , biology , immunology , gene , germinal center , biochemistry , chromosome
Summary Distinguishing Burkitt lymphoma (BL) from B cell lymphoma, unclassifiable with features intermediate between diffuse large B‐cell lymphoma (DLBCL) and BL (DLBCL/BL), and DLBCL is challenging. We propose an immunohistochemistry and fluorescent in situ hybridization (FISH) based scoring system that is employed in three phases – Phase 1 (morphology with CD10 and BCL2 immunostains), Phase 2 (CD38, CD44 and Ki‐67 immunostains) and Phase 3 (FISH on paraffin sections for MYC , BCL2 , BCL6 and immunoglobulin family genes). The system was evaluated on 252 aggressive B‐cell lymphomas from Europe and from sub‐Saharan Africa. Using the algorithm, we determined a specific diagnosis of BL or not‐BL in 82%, 92% and 95% cases at Phases 1, 2 and 3, respectively. In 3·4% cases, the algorithm was not completely applicable due to technical reasons. Overall, this approach led to a specific diagnosis of BL in 122 cases and to a specific diagnosis of either DLBCL or DLBCL/BL in 94% of cases that were not diagnosed as BL. We also evaluated the scoring system on 27 cases of BL confirmed on gene expression/microRNA expression profiling. Phase 1 of our scoring system led to a diagnosis of BL in 100% of these cases.