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WHAT IS IT?
Burkitt lymphoma: is a neoplastic proliferation of intermediate-sized B-cells (that are CD20+). It is caused by the 8:14 translocation (which activates c-myc the transcription factor). This is a subcategory of non-Hodgkins lymphomas. There are three main variants:
- Endemic: common in equatorial Africa. Linked to EBV and also possible co-malria infection (that makes it difficult to fight off EBV virus)
- Sporadic: outside of Africa, but also associated with EBV.
- Immunodeficiency-associated: literally associated with immune suppression (such as AIDS)
WHY IS IT A PROBLEM?
The translocation event moves the proto-oncogene c-myc onto the Ig heavy chain on chromosome 14. This leads to overexpression of c-myc, which ultimately promotes cell growth (that is neoplastic).
WHAT MAKES US SUSPECT IT?
Risk factors: EBV, young children, AIDS, immunosuppressive medications
Extranodal mass: common presentations by subtype below
African form: This involves the lymph nodes of the head and neck (lymphadenopathy). Usually presents in the jaw (invaded bone marrow) but can also involve the kidney, ovaries, and/or the adrenals.
![Clinical presentation of the African form of Burkitt's lymphoma (source)](http://www.stepwards.com/wp-content/uploads/2016/01/Large_facial_Burkitts_Lymphoma.jpg)
Sporadic form: usually involves abdomen (distal small bowel: ileocecum/peritoneum)
HOW DO WE CONFIRM A DIAGNOSIS?
Biopsy: starry sky appearance with sheets of lymphocytes (interspersed with macrophages called histiocytes). While it originates form the germinal center, it does not ususally form follicles.
![Classic "Starry sky" appearance of Burkitt's lymphoma (source)](http://www.stepwards.com/wp-content/uploads/2016/01/Burkitt_lymphoma_starry_sky_1.jpg)
HOW DO WE TREAT IT?
Short-term, high dose chemotherapy.
HOW WELL DO THE PATIENTS DO?
This varies, however younger patients typically have a better prognosis compared to older ones.
WAS THERE A WAY TO PREVENT IT?
Limiting the overuse of immunosuppressive medications
WHAT ELSE ARE WE WORRIED ABOUT?
AIDS: immunosuppressive infections (like AIDS) have been linked to this condition.
OTHER HY FACTS?
Characterized by a high mitotic index: this means that at any given time a high proportion of cells within the tumor are undergoing mitosis.
Page Updated: 01.13.2016