Starry sky pattern in hematopoietic neoplasms: A review of pathophysiology and differential diagnosis

Janelyn L. Dy-Ledesma, Joseph D. Khoury, Rose Lou Marie C. Agbay, Mar Garcia, Roberto N. Miranda, L. Jeffrey Medeiros

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations


The starry sky pattern is a distinctive histologic feature wherein a rapidly proliferating hematolymphoid neoplasm contains scattered histiocytes with abundant pale cytoplasm in a background of monomorphic neoplastic cells. The cytoplasm of these histiocytes typically contains cellular remnants, also known as tingible bodies, incorporated through active phagocytosis. Although common and widely recognized, relatively little is known about the pathophysiological underpinnings of the starry sky pattern. Its resemblance to a similar pattern seen in the germinal centers of secondary follicles suggests a possible starting point for understanding the molecular basis of the starry sky pattern and potential routes for its exploitation for therapeutic purposes. In this review, we discuss the historical, pathophysiological, and clinical implications of the starry sky pattern.

Original languageEnglish (US)
Pages (from-to)343-355
Number of pages13
JournalAdvances in anatomic pathology
Issue number6
StatePublished - Nov 1 2016
Externally publishedYes


  • Burkitt lymphoma
  • anaplastic large-cell lymphoma
  • apoptosis
  • germinal center
  • lymphoma
  • myeloid sarcoma
  • starry sky pattern

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine


Dive into the research topics of 'Starry sky pattern in hematopoietic neoplasms: A review of pathophysiology and differential diagnosis'. Together they form a unique fingerprint.

Cite this