Burkitt lymphoma, one of the more common forms of non-Hodgkin lymphoma, has a variety of clinical presentations

‘A radiologic investigation is necessary to diagnose Burkitt lymphoma, and early detection is imperative because of its aggressive nature.’

Burkitt lymphoma, an aggressive subtype of non-Hodgkin lymphoma (NHL), accounts for 40% of all NHL cases in the United States. This high-grade, fast-growing form of lymphoma starts in the immune system’s B cells and has a doubling time of 24 to 48 hours. It affects children of all ages, but it is most common in boys under age 14.

Diagnosing Burkitt lymphoma

According to Ashok B. Raj, M.D., pediatric hematologist/oncologist at Norton Children’s Cancer Institute, affiliated with the UofL School of Medicine, there are a variety of clinical presentations of Burkitt lymphoma, because it may present in various parts of the body.

“A radiologic investigation is necessary for diagnosis, and early detection is imperative because of its aggressive nature,” Dr. Raj said. “A biopsy also is needed for studies leading to the diagnosis of Burkitt lymphoma.”

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Awareness of the specific appearances of the condition plays an important role in quick detection and treatment. “Imaging Features of Burkitt Lymphoma in Pediatric Patients,” published in Diagnostic and Interventional Radiology, provides some of its most common imaging features.

Clinical variants of Burkitt lymphoma

Sporadic Burkitt lymphoma is the most common variant in the United States and typically develops in the abdomen. A large abdominal tumor may be present, with the ileocecal region being the most common site of involvement. Symptoms may include abdominal pain, nausea and vomiting. The pharynx area, particularly the Waldeyer ring, also may be affected.

Endemic Burkitt lymphoma is linked to Epstein-Barr virus (EBV) infection and is the most common variant in Africa, where malaria is also endemic. It most commonly appears in the head and neck area, developing in the head, neck, jaw or other facial bones. Symptoms may include visible facial swelling or rapidly growing lymph nodes in those areas.

Other symptoms may include swollen lymph nodes, fatigue, fever, night sweats, weight loss, coughing or trouble breathing.

Burkitt lymphoma also may be immunodeficiency-associated, which is more common among patients with HIV infections.

Treatment options

Burkitt lymphoma is curable, and chemotherapy is highly effective. Treatment may include chemoimmunotherapy, with the addition of the monoclonal antibody rituximab. Chemotherapy may be injected into the spinal fluid if the lymphoma is growing around the head or neck.

Prior to starting chemotherapy, surgery may be necessary if a large tumor is detected and is contained to one area. Due to the cancer’s aggressive nature, it’s important to start treatment as soon as possible.

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