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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.
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