A 5 yr old boy presented to the ER with vomiting and abdominal distension. Abdominal imaging showed mass in the ileocecal region. Histopathological examination of biopsy from the region showed diffuse infiltrate of lymphoid cells admixed with macrophages giving a ‘starry-sky’ appearance. Which of the following translocations is unlikely to be seen in this condition?
**Core Concept:** The question is about a pediatric patient presenting with abdominal symptoms and imaging findings consistent with a lymphoproliferative disorder. The biopsy shows a characteristic histopathological pattern called the 'starry-sky' appearance, which is indicative of a non-Hodgkin lymphoma (NHL). NHL is a group of lymphoproliferative disorders characterized by abnormal proliferation of lymphocytes.
**Why the Correct Answer is Right:** The correct answer is **D.** Non-Hodgkin lymphoma (NHL) is characterized by the infiltration of malignant lymphoid cells, which can be seen in the provided histopathological examination. NHL can involve various parts of the body, including the gastrointestinal tract, and the given biopsy demonstrates the characteristic 'starry-sky' appearance.
**Why Each Wrong Option is Incorrect:**
A. Burkitt lymphoma: Although it can present with gastrointestinal involvement, it typically shows a monotonous lymphoid infiltrate without the 'starry-sky' appearance.
B. Hodgkin lymphoma: This is another type of lymphoma, but the 'starry-sky' appearance is specific to NHL.
C. Peripheral T cell lymphoma: This subtype of NHL may present with gastrointestinal involvement, but it also lacks the 'starry-sky' appearance.
**Why the Correct Answer is Right:** The correct answer (D) is right because the 'starry-sky' appearance is a distinctive feature of diffuse large B cell lymphoma (DLBCL). DLBCL is a subtype of Non-Hodgkin lymphoma (NHL), which is the correct diagnosis given the clinical presentation and imaging findings. The 'starry-sky' appearance helps to differentiate DLBCL from other subtypes of NHL, Hodgkin lymphoma, and other lymphoproliferative disorders.
**Why Each Wrong Option is Incorrect:**
A. Burkitt lymphoma: Although it can present with gastrointestinal involvement, it typically shows a monotonous lymphoid infiltrate without the 'starry-sky' appearance.
B. Hodgkin lymphoma: This is another type of lymphoma, but the 'starry-sky' appearance is specific to NHL.
C. Peripheral T cell lymphoma: This subtype of NHL may present with gastrointestinal involvement, but it also lacks the 'starry-sky' appearance.
**Core Concept:** The 'starry-sky' appearance is a characteristic feature of diffuse large B cell lymphoma (DLBCL) and helps in differentiating it from other lymphoproliferative disorders. DLBCL is a subtype of Non-Hodgkin lymphoma (NHL) and can involve the gastrointestinal tract.
**Why Each Wrong Option is Incorrect:**
A. Burkitt lymphoma: Burkitt lymphoma is a subtype of NHL, but it shows a monotonous lymphoid infiltrate without the 'starry-sky' appearance.
B. Hodgkin lymphoma: Hodgkin lymphoma is another subtype of NHL, but it lacks the 'starry-sky' appearance.
C. Peripheral T cell lymphoma