Burkitt lymphoma (BL) is an aggressive B-cell lymphoma that predominantly affects children.
Burkitt lymphoma is the most common (40%) type of non-Hodgkin lymphoma in childhood. The median age of Burkitt lymphoma is eight years, and it has a male predominance (M:F = 4:1) 1. It is less common in adults, accounting for 1-2% of lymphomas 4,5.
There are geographic differences with Burkitt lymphoma, which is considered endemic in parts of Africa (rates are up to 50 times higher than in the USA), with sporadic cases occurring elsewhere.
- post-transplant immunosuppression
Burkitt lymphoma affects many organs, and this affects presentation. Extranodal involvement is common (~30%) at presentation, most often presenting as an abdominal or pelvic mass. Most patients present with widespread disease.
Three forms of Burkitt lymphoma have been described 1, 2:
- endemic BL: linked to EBV and Plasmodium falciparum malaria infections
- sporadic BL: aetiology unknown
- immunodeficiency-associated BL: occurs in patients with HIV, post-transplant or congenital immunosuppression
Burkitt lymphoma is an aggressive tumour with a doubling time of 24 hours. It can present in a wide variety of locations:
- head and neck, e.g. facial bones, Waldeyer's ring
- pleural space (~70%)
- gastrointestinal tract, especially the ileocaecal region
- mesentery, peritoneum, retroperitoneum
- gonads (~75%)
Nodal involvement is more common in adults than in children 5.
Radiographic features vary widely depending on organ involvement:
- abdominal manifestations of Burkitt lymphoma
- musculoskeletal manifestations of Burkitt lymphoma
- head and neck manifestations of Burkitt lymphoma
Treatment and prognosis
Burkitt lymphoma can be treated with chemotherapy. In children, the prognosis is good with survival rates >90%. In adults, the prognosis is poorer, with a 5-year survival rate of ~50% and is even worse with bone marrow or CNS involvement (>30% 5-year survival rate) 4.
History and etymology
First described by Denis Parsons Burkitt, an Irish surgeon, in 1958 in Uganda, Africa.
- other forms of high-grade B-cell lymphoma
- Crohn disease may mimic Burkitt lymphoma on ultrasound, barium studies and CT 3
- overview of lymphoma
WHO classification of tumours of haematopoietic and lymphoid tissues
- Hodgkin lymphoma
mature B-cell lymphoma
- Burkitt lymphoma
- follicular lymphoma
- lymphoplasmacytic lymphoma (Waldenström's macroglobulinaemia)
- lymphomatoid granulomatosis
- mantle cell lymphoma
- mature T-cell and NK-cell lymphoma
- post-transplant lymphoproliferative/lymphoproliferation disorders
- mature B-cell lymphoma
- location-specific lymphomas
- central nervous system
- head and neck lymphoma
- thoracic lymphoma
- gastrointestinal lymphoma
- hepatobiliary lymphoma
- genitourinary lymphoma
- musculoskeletal lymphoma
- cutaneous lymphoma
- lymphoma staging
- 1. Biko DM, Anupindi SA, Hernandez A et-al. Childhood Burkitt lymphoma: abdominal and pelvic imaging findings. AJR Am J Roentgenol. 2009;192 (5): 1304-15. doi:10.2214/AJR.08.1476 - Pubmed citation
- 2. Mbulaiteye SM, Clarke CA, Morton LM et-al. Burkitt lymphoma risk in U.S. solid organ transplant recipients. Am. J. Hematol. 2013;88 (4): 245-50. doi:10.1002/ajh.23385 - Free text at pubmed - Pubmed citation
- 3. Seibert JJ, James CA. Pediatric radiology casebase. Thieme. ISBN:0865776970. Read it at Google Books - Find it at Amazon
- 4. Diviné M, Casassus P, Koscielny S et-al. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann. Oncol. 2005;16 (12): 1928-35. doi:10.1093/annonc/mdi403 - Pubmed citation
- Ferry JA. Burkitt's lymphoma: clinicopathologic features and differential diagnosis. Oncologist. 2006;11 (4): 375-83. doi:10.1634/theoncologist.11-4-375 - Pubmed citation