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Figure 8b. Burkitt lymphoma in a 7-year-old boy who presented with a 3-week history of vomiting, abdominal pain, and intermittent diarrhea. (a) Contrast-enhanced CT scan shows an ileocolic intussusception (arrowheads) with thickening of the terminal ileum. The hypoattenuating ileal mesenteric fat with mesenteric vessels extends into the cecal lumen (*). (b) Low-power photomicrograph (original magnification, x4; H-E stain) shows polypoid tumor invasion of the bowel wall (long arrow) through the muscle (short arrow). (c) High-power photomicrograph (original magnification, x600; H-E stain) shows a diffuse infiltrate of small to medium-sized blast cells, a finding that is typical of Burkitt lymphoma. Note that the blast cells are smaller than those shown in Figure 2c (diffuse large B-cell lymphoma). (d) High-power photomicrograph (original magnification, x600; immunohistochemical stain MIB1 for Ki 67, a cell cycle proliferation marker) shows proliferating cells, virtually all (>99%) of which are "in cycle" (ie, dividing), a typical finding in Burkitt lymphoma. The cells also stained positively with CD20, a marker for B cells.
