Publication protocol
Immunophenotype was also determined by flow cytometry of cellular suspension obtained by fine needle aspiration biopsy or by ultrasound-guided fine needle aspiration biopsy (cases with bulky abdominal mass, stomach, and abdominal lymph node involvement) of the involved lymph nodes, tonsils, and extranodal tumors performed by a hematopathologist. Cells from patients with histopathologically confirmed or suspected of Burkitt lymphoma, were incubated with a panel of monoclonal antibodies1, 4, 12 (for staining procedure and a list of antibodies see Supplementary Methods and Supplementary Table 2). Antigen expression (Figures 2 and 3, and Supplementary Table 4) was quantified by FACSCalibur and FACSCanto II cytometers (Becton Dickinson, BD), and was categorized according to the percentages of positive cells into three groups, marked: ‘(–)’ – no expression (<20% of neoplastic cells), ‘(+/–)’ – expression in >20% but <100% of cells, and ‘(+)’ – in 100% of lymphoma cells. A quantitative expression of CD(19/20/22/23/52/79β/81), FMC7, HLA-DR, BCL6, and CD(5/25/38/43/44/45/52/62L/71/200), BCL2, and CD(16/56 and 56) in neoplastic cells was evaluated as median fluorescence intensity value related to the median fluorescence intensity of these antigens on B-, T-, and NK-lymphocytes, respectively (a representative example of CD38 expression is shown in the Figure 2b, A, B). This approach enables to quantify the expression of a given antigen as higher (+)↑ or weaker (+)↓ in Burkitt-like lymphoma with 11q aberration and in Burkitt lymphoma cells than in control lymphocytes, as well as to compare the expression of pan-B antigens in Burkitt-like lymphoma with 11q aberration and Burkitt lymphoma cells (ie, CD19 vs CD20 vs CD22, using monoclonal antibodies conjugated with the same fluorochrome), as described.1, 4, 12 ‘Dim’ (lower and heterogeneous) or ‘bright’ (higher and homogeneous) expression was defined as previously.4, 12 Simultaneously, cytological smears were stained with a hematoxylin-eosin and May-Grünwald-Giemsa for morphological evaluation (Figure 2a).
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