This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Unknown
[{'content': 'A 16-yrs-old girl presents with bowel obstruction. Laparotomy reveals markedly enlarged para-aortic lymph nodes. Biopsy of lymph nodes exhibit a diffuse neoplastic infiltrate of small, round lymphocytes with a “starry sky” appearance on low power. The cytoplasm of some of the lymphocytes is vacuolated and fat stains are positive. You would expect the neoplastic cells to demonstrate a: \nSelect and explain. \nA. Positive non-specific esterase stain of the cells, B. Positive specific esterase stain of the cells, C. Low leukocyte alkaline phosphatase score, D. t(8;14) translocation', 'role': 'user'}, {'content': 'Answer: D \nExplanation: The patient has Burkitt lymphoma (Lukes-Collins; small non-cleaved), which is the most common malig\xadnant lymphoma in children. Approximately one third of all childhood lymphomas in the United States are of the Burkitt type. There is an Mrican and a North American variant. The relationship of Burkitt to the Epstein-Barr virus is more secure with the Mrican than the North American variant. The Mrican variant has a predilection for the jaw, while the North Ameri\xadcan variant is more often an abdominal mass, located in the ileocecal region, ovary, or retroperitoneum. The lymph nodes are diffusely involved with monotonous, round, non-cleaved cells with numerous mitoses (very aggressive cancer) punctuated by clear spaces with macrophages containing debris ("tingible" macro\xadphages) giving the impression of a "starry sky appear\xadance," the stars representing the macrophages and the black of night the lymphocytes. The neoplastic B cells have a characteristic t(8;14) translocation where the c-myc oncogene is translocated from chromosome 8 to chromosome 14. Burkitt cells contain vacuoles that contain lipid, which stains positively with oil red O. It is a high grade lymphoma with a predilection for metastasis to the bone marrow and other organs.', 'role': 'assistant'}]