Burkitt lymphoma is an aggressive B-cell lymphoma predominantly affecting children.
Burkitt lymphoma is the most common (40%) type of non-Hodgkin lymphoma in childhood. Median age is eight years with a male predominance (M:F = 4:1) 1. It is less common in adults, accounting for 1-2% of lymphomas 4,5.
It is considered endemic in parts of Africa where rates are up to 50 times higher than in the USA. Cases occur sporadically outside of the tropics.
- 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 Burkitt lymphoma: linked to Epstein-Barr virus (EBV) and Plasmodium falciparum malaria infections
- sporadic Burkitt lymphoma: etiology unknown
- immunodeficiency-associated Burkitt lymphoma: occurs in patients with HIV, post-transplant or congenital immunosuppression
Burkitt lymphoma is an aggressive tumor with a doubling time of 24 hours. It can present in a wide variety of locations:
- head and neck, e.g. facial bones, Waldeyer ring
- pleural space (~70%)
- gastrointestinal tract, especially the ileocecal 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 (1911-1993), an Irish surgeon, in 1958 in Uganda, Africa 6,7.
- other forms of high-grade B-cell lymphoma
- Crohn disease may mimic Burkitt lymphoma on ultrasound, barium studies, and CT 3
- 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
- 5. 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
- 6. Epstein A, Eastwood MA. Denis Parsons Burkitt - 28 February 1911--23 March 1993. (1995) Biographical memoirs of fellows of the Royal Society. Royal Society (Great Britain). 41: 87-102. Pubmed
- 7. Walusansa V, Okuku F, Orem J. Burkitt lymphoma in Uganda, the legacy of Denis Burkitt and an update on the disease status. (2012) British journal of haematology. 156 (6): 757-60. doi:10.1111/j.1365-2141.2012.09027.x - Pubmed
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