"Stary sky" appearance is seen in -
Burkitt's lymphoma
Mantle cell lymphoma
Extra nodal marginal Zone B-cell lymphoma of MALT type
Chronic myeloid leukemia
The tumor consists of sheets of a monotonous (i.e. similar in size and morphology) population of medium-sized lymphoid cells with high proliferative activity and apoptotic activity. The "starry sky" appearance seen under low power is due to scattered tingible body-laden macrophages (macrophages containing dead apoptotic tumor cells). The old descriptive term of "small non-cleaved cell" is misleading. The tumor cells are mostly medium in size (i.e. tumor nuclei size similar to that of histiocytes or endothelial cells). "Small non-cleaved cells" are compared to "large non-cleaved cells" of normal germinal center lymphocytes. Tumor cells possess small amount of basophilic cytoplasm with three to four small nucleoli. The cellular outline usually appears squared off.
Haematology