ĐẶC ĐIỂM MÔ BỆNH HỌC VÀ HÓA MÔ MIỄN DỊCH CỦA LYMPHÔM BURKITT: NGHIÊN CỨU ĐA TRUNG TÂM TẠI THÀNH PHỐ HỒ CHÍ MINH

Abstract

Introduction: Burkitt lymphoma is an aggressive but potentially curable disease. Diagnosis can be established using immunohistochemistry (IHC) in combination with histopathological features, particularly in resource-limited settings. This study aimed to investigate the clinical, histopathological, and immunohistochemical characteristics of cases diagnosed with Burkitt lymphoma, analyze the relationships among these features, and contribute to a better understanding of Burkitt lymphoma characteristics in Vietnam. Methods: A descriptive case series study of patients diagnosed with Burkitt lymphoma at Ho Chi Minh City Oncology Hospital, Children's Hospital No.1, and the Department of Embryology, Histology, and Pathology, University of Medicine and Pharmacy at Ho Chi Minh City, from January 2020 to December 2024. Results: Children and adlescents accounted for the majority of cases (80%), with a male predominance (71.4%). Tumor sites: the gastrointestinal tract, abdominal cavity, and peripheral lymph nodes accounted for 20%, 17.1%, and 14.3% of cases, respectively. Tumors measuring < 100 mm comprised 85.2% of cases. Typical tumor cell morphology, “starry-sky” and “square-off” appearances, and tumor necrosis were observed in 85.7%, 82.9%, and 74.3%, and 25.7% of cases, respectively. All cases exhibited a diffuse growth pattern, with no granulomatous reaction identified. The mean mitotic index was 50 ± 19/10 high power field (HPF). All cases showed positive immunoreactivity for CD20 and CD10, and were negative for CD3, CD5, Cyclin D1, BCL2, CD34, and TdT. Most cases expressed BCL6 (30/33) and lacked MUM1 expression (27/32). The mean expression of Ki-67 and c-MYC were 97.1 ± 1.2% and 88.4 ± 4.7%, respectively. Conclusion: Burkitt lymphoma predominantly affects children and adolescents, with a higher incidence in males. The most frequent tumor sites were the gastrointestinal tract and abdominal cavity. Most tumors measured less than 100 mm. Histologically, nearly all cases showed diffuse growth pattern, typical tumor cell morphology, and characteristic “starry-sky” and “square-off” appearances. Tumor necrosis is uncommon, and the tumors exhibit a high mitotic index. All cases were positive for CD10 and CD20, and negative for CD3, CD5, Cyclin D1, BCL2, CD34, and TdT. The majority expressed BCL6 and lacked MUM1 expression; cases negative for BCL6 tended to show higher MUM1 expression. All cases demonstrated Ki-67 > 95% and c-MYC ≥ 80%.