Starry-sky pattern

Starry-sky pattern is seen on bone marrow, lymph node and extranodal masses sections

• Characteristic starry-sky pattern with sheets of monomorphic neoplastic lymphoid cells and interspersed histiocytes (arrows) in anal Burkitt’s lymphoma.
• The tumor cells have round nuclei with dense chromatin and multiple small nucleoli.
• Note also apoptotic figures (arrowheads).

Starry-sky pattern – Cases other than Burkitt lymphoma

“starry-sky” pattern is a characteristic feature almost exclusively observed in hematolymphoid neoplasms, particularly in Burkitt lymphoma

However, it has also been observed in other lymphoma subtypes, including DLBCL – [double-expressor diffuse large B-cell lymphoma].

Aggressive clinicopathologic features in double-expressor diffuse large B-cell lymphoma

•  c-MYC overexpression
• aberrant CD5 expression
• adverse survival in double expressor lymphoma

What is Double expressor lymphoma?

Double expressor lymphoma (DEL) is a high-risk subtype of DLBCL characterized by the overexpression of the c-MYC and BCL2 proteins without underlying gene rearrangement