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Burkitt's lymphoma: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Burkitt's lymphoma is B-cell lymphoma, found predominantly in women. There are forms of endemic (African), sporadic (non-African) and associated with immunodeficiency.
Burkitt's lymphoma is endemic in central Africa and accounts for up to 30% of children's lymphomas in the United States. Endemic for Africa manifests itself in the form of lesions of facial bones, jaws. Non-African Burkitt's lymphoma is manifested by damage to the abdominal organs, often occurring in the area of the ileocecal valve or mesentery. In adults, kidneys, ovaries, mammary glands are affected, the disease can be initially widespread, often involving the liver, spleen and bone marrow. CNS lesion is often recorded at the time of diagnosis or relapse of the disease.
Burkitt's lymphoma is the fastest growing tumor of a person with a high mitotic cycle of monoclonal-proliferating B cells, the presence of characteristic benign macrophages that look like a "starry sky" due to the absorption of apoptotic malignant lymphocytes. Genetic translocations that include the C-tus gene on chromosome 8 and the immunoglobulin heavy chain on chromosome 14 are determined . In endemic 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.
The diagnosis is based on a lymph node biopsy or other localization tissue where there is a suspicion of having a lesion. Staging is based on the results of CT, bone marrow biopsy, cytological examination, 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 scheme (cyclophosphamide, vincristine, doxorubicin, methotrexate, ifosfamide, etoposide, cytarabine) can lead to cure in 90% of children and adults. It is necessary to carry out prevention of CNS damage. The development of tumor lysis syndrome is a frequent phenomenon during therapy, therefore it is necessary to conduct adequate intravenous hydration with electrolyte level control (especially K and Ca), reception of allopurinol.
If the patient has an intestinal obstruction caused by a tumor and the tumor is completely resected with diagnostic laparotomy, additional courses of aggressive chemotherapy are indicated. In the absence of the effect of initial therapy, salvage therapy is often ineffective, which emphasizes the importance of very aggressive initial therapy.
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