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Burkitt Lymphoma

Definition

Burkitt lymphoma is a high-grade malignancy of B-lymphocyte origin that usually affects the jaws.

Etiology

Epstein-Barr virus has been implicated in the pathogenesis of Burkitt’s lymphoma.

Classification

There are three types of Burkitt lymphoma: a) African, b) endemic, and c) American or sporadic.

Main Clinical Features

•Pain, tenderness, paresthesia, bone destruction, and tooth mobility and loss are common symptoms and signs

•A large ulcerating or nonulcerating soft tissue mass may also be present in the oral mucosa and gingiva

•The maxilla is more frequently affected than the mandible

•Usually affects children 2-12 years of age

Diagnosis

The clinical diagnosis should be confirmed by a biopsy and histopathologic examination.

Differential Diagnosis

•Non-Hodgkin lymphoma

•Osteosarcoma

•Chondrosarcoma

•Ewing’s sarcoma

•Multiple myeloma

•Cherubism

•Central giant cell granuloma

•Odontogenic tumors

Treatment

•Chemotherapy—CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) regimens or more complex chemotherapy-is the treatment of choice, either alone or in combination with radiotherapy and surgery. This regimen has improved the prognosis of Burkitt lymphoma.

•Radiation therapy is the second treatment choice, either alone or in combination with chemotherapy.

•Surgery can also be used for early localized lesions.

References

Hesseling PB, Broadhead R. Molyneux E, et al. Malawi pilot study of Burkitt lymphoma treatment. Med Pediatr Oncol 2003;41:532–540.

Levine AM. Challenges in the management of Burkitt’s lymphoma. Clin Lymphoma 2002;3(suppl 1):S19-S25.

Philip T, Bergeron C. Burkitt’s lymphoma: A model for pediatric oncology. Arch Pediatr 2000;7:924–926.

Shapira J, Peylan-Ramu N. Burkitt’s lymphoma. Oral Oncol 1998;34:15–23.

Wang ES, Straus DJ, Teruya-Feldstein J. et al. Intensive chemotherapy with cyclophosphamide, doxorubicin, high-dose methotrexate-ifosfamide, etoposide. and high-dose cytarabine (CODOX-M/IVAC) for human immunodeficiency virus-associated Burkitt’s lymphoma. Cancer 2003;98:1196–1205.

Weinthal JA, Goldman SC, Lenarsky C. Successful treatment of relapsed Burkitt’s lymphoma using unrelated cord blood transplantation as consolidation therapy. Bone Marrow Transplant 2000;25:1311–1313.