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Berkitt's lymphoma: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Burkitt lymphoma is a B-cell lymphoma that occurs predominantly in women. There are endemic (African), sporadic (non-African), and immunodeficiency-associated forms.
Burkitt lymphoma is endemic in central Africa and accounts for up to 30% of childhood lymphomas in the United States. Forms endemic to Africa manifest as lesions of the facial bones and jaw. Non-African Burkitt lymphoma manifests as lesions of the abdominal organs, often arising in the area of the ileocecal valve or mesentery. In adults, the kidneys, ovaries, and mammary glands are affected; the disease can be initially widespread, often involving the liver, spleen, and bone marrow. CNS involvement is often recorded at the time of diagnosis or during a relapse of the disease.
Burkitt lymphoma is the fastest growing human tumor with a high mitotic cycle of monoclonally proliferating B cells, the presence of characteristic benign macrophages that have a "starry sky" appearance due to the absorption of apoptotic malignant lymphocytes. Genetic translocations are determined, including the C-myc gene on chromosome 8 and the immunoglobulin heavy chain on chromosome 14. In the endemic form of lymphoma, the disease is closely associated with the Epstein-Barr virus, but the role of this virus in the etiology of the disease remains unclear.
Diagnosis is based on biopsy of a lymph node or tissue from another location where there is a suspicion of a lesion. Staging is based on the results of CT, bone marrow biopsy, cytology, PET.
The necessary examination and treatment should be performed as soon as possible, given the rapid growth of the tumor. The use of the CODOX-M/VAC regimen (cyclophosphamide, vincristine, doxorubicin, methotrexate, ifosfamide, etoposide, cytarabine) can lead to a cure in 90% of children and adults. It is necessary to carry out prophylaxis of CNS damage. The development of tumor lysis syndrome is a frequent occurrence during therapy, so it is necessary to carry out adequate intravenous hydration with monitoring of electrolyte levels (especially K and Ca), and allopurinol intake.
If the patient has a bowel obstruction caused by a tumor and the tumor is completely resected at exploratory laparotomy, additional courses of aggressive chemotherapy are indicated. If initial therapy fails, salvage therapy is often ineffective, highlighting the importance of very aggressive initial therapy.
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