2020 Volume 59 Issue 2 Pages 92-98
Background : We report herein on an autopsy case of Burkitt lymphoma (BL) in an HIV-infected patient.
Case : An HIV-positive Japanese male in his sixties with a history of meningoencephalitis developed a left axillary lymph node mass, and a biopsy was performed. H & E staining of the specimen showed diffuse proliferation of atypical large lymphoid cells, which suggested diffuse large B-cell lymphoma (DLBCL). The immunohistochemical findings revealed that tumor cells were positive for CD10, Bcl-6, and were negative for CD3 and Bcl-2. c-Myc was positive in 84% of the tumor cells and the Ki-67 labeling index was 95%. Taken together, the diagnosis was B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and BL. The patient died due to central nerve invasion of the tumor despite chemotherapy. At autopsy, a cytological examination was performed employing cerebrospinal fluid. Papanicolaou staining showed moderate to large tumor cells with pleomorphic nuclei. Cytoplasmic vacuoles were observed by Giemsa staining in 59% of the tumor cells, which suggested BL.
Conclusion : HIV-associated BL often presents with atypical morphological findings especially in the Japanese population. Intracytoplasmic vacuoles seen in Giemsa-stained specimens is one of the important features in diagnosing BL.
