Burkitt's lymphoma classification: Difference between revisions

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{{Burkitt's lymphoma}}
{{Burkitt's lymphoma}}
{{CMG}}
{{CMG}}; {{AE}} {{AS}}
==Overview==
==Overview==
Burkitt's lymphoma may be classified according to the [[World Health Organization]] ([[WHO]]) classification into 3 clinical variants. The clinical variants are endemic Burkitt's lymphoma, sporadic Burkitt's lymphoma, and immunodeficiency-associated Burkitt's lymphoma.
==Classification==
==Classification==
Currently Burkitt's lymphoma can be divided into three main clinical variants: the endemic, the sporadic and the immunodeficiency-associated variants.   
Burkitt's lymphoma may be classified according to WHO classification into 3 clinical variants:
* The endemic variant occurs in equatorial Africa. It is the most common malignancy of children in this areaChildren affected with the disease often also had chronic [[malaria]] which is believed to have reduced resistance to the Epstein-Barr virus and allowed it to take hold. Disease characteristically involves the jaw or other facial bone, distal ileum, cecum, ovaries, kidney or the breast.
* Endemic Burkitt's lymphoma <ref name="pmid9454768">{{cite journal| author=Tao Q, Robertson KD, Manns A, Hildesheim A, Ambinder RF| title=Epstein-Barr virus (EBV) in endemic Burkitt's lymphoma: molecular analysis of primary tumor tissue. | journal=Blood | year= 1998 | volume= 91 | issue= 4 | pages= 1373-81 | pmid=9454768 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9454768 }} </ref>
* Sporadic Burkitt's lymphoma<ref name="pmid30042102">{{cite journal| author=Ng JY, Thompson RJ, Lam A, Nigam S| title=Sporadic Burkitt's lymphoma masquerading as an intussuscepted Meckel's diverticulum in a 9-year-old child. | journal=BMJ Case Rep | year= 2018 | volume= 2018 | issue=  | pages=  | pmid=30042102 | doi=10.1136/bcr-2018-224333 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30042102 }} </ref>
* Immunodeficiency-associated Burkitt's lymphoma<ref name="pmid28506687">{{cite journal| author=Linke-Serinsöz E, Fend F, Quintanilla-Martinez L| title=Human immunodeficiency virus (HIV) and Epstein-Barr virus (EBV) related lymphomas, pathology view point. | journal=Semin Diagn Pathol | year= 2017 | volume= 34 | issue= 4 | pages= 352-363 | pmid=28506687 | doi=10.1053/j.semdp.2017.04.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28506687  }} </ref>
It is almost impossible to differentiate these three clinical variants based on histology (i.e. microscopic appearance) or [[immunophenotype]].  


* The sporadic type of Burkitt lymphoma (also known as "non-African") is another form of [[non-Hodgkin lymphoma]] found outside of Africa.  The tumor cells have a similar appearance to the cancer cells of classical African or endemic Burkitt lymphoma. Again it is believed that impaired immunity provides an opening for development of the [[Epstein-Barr virus]]. Non-Hodgkins, which includes Burkitt's, accounts for 30-50% of childhood lymphoma.  Jaw is less commonly involved, comparing with the endemic variant. Ileo-cecal region is the common site of involvement.
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
 
|+ '''Classification Based on The Geographic Distribution and Clinical Presentation'''
* Immunodeficiency-associated Burkitt lymphoma is usually associated with [[HIV]] infection or occurs in the setting of post-transplant patients who are taking immunosuppressive drugs. Actually, Burkitt lymphoma can be the initial manifestation of[[AIDS]]
! style="background: #4479BA;; color:#FFF;" | Name
 
! style="background: #4479BA;; color:#FFF;" | Description
By morphology (i.e. microscopic appearance) or [[immunophenotype]], it is almost impossible to differentiate these three clinical variants. Immunodeficiency-associated Burkitt lymphoma may demonstrate more plasmacytic appearance or more pleomorphism, but these features are not specific.
|-
| style="text-align: center; padding: 5px 5px; background: #F5F5F5;" | '''Endemic Burkitt's lymphoma'''
(African Burkitt's lymphoma)
| style="padding: 5px 5px; background: #F5F5F5;" |
*The endemic form always presents as a jaw or [[facial bone]] [[tumor]]
*Primary involvement of the [[abdomen]] is not very common
*The primary tumor can disseminate to the extranodal sites such as the [[mesentery]], [[ovary]], [[Testicle|testis]], [[Kidney CA|kidney]], [[breast]], and [[meninges]]
*Peripheral [[Lymph node|lymph nodes]], [[mediastinum]], and [[spleen]] involvement are uncommon
*[[Bone marrow]] involvement is noted in less than 10 percent of patients at the time of initial diagnosis but is a common complication of treatment-resistant disease.
|-
| style="text-align: center; padding: 5px 5px; background: #F5F5F5;" | '''Sporadic Burkitt's lymphoma'''
(Non-African or Non-endemic Burkitt's lymphoma)
| style="padding: 5px 5px; background: #F5F5F5;" |
* The most common type of Burkitt's lymphoma in North America and Europe
* Sometimes associated with the [[Epstein-Barr virus]], but in many cases this virus is not present
* [[Non-Hodgkin's lymphoma]], which includes Burkitt's, accounts for 30-50% of childhood [[lymphoma]]
*This form usually has an abdominal presentation, most often with massive dissemination and [[ascites]]; the distal [[ileum]], [[stomach]] , [[cecum]] and/or mesentery, kidney, testis, ovary, breast, bone marrow, or [[Central nervous system|central nervous system (CNS)]] are involved
*Presenting symptoms can be those that are like [[bowel obstruction]] or [[gastrointestinal bleeding]], often disguised as [[Appendicitis|acute appendicitis]] or [[intussusception]]
*Almost 25 percent of cases will have presentation of the disease in the [[jaw]] or [[facial bones]]
*[[Lymphadenopathy]], is generally localized
*Bone marrow and CNS involvement occurs in about 30 and 15 percent of cases, respectively, but are likely complications of recurrent or treatment resistant disease
|-
| style="text-align: center; padding: 5px 5px; background: #F5F5F5;" | '''Immunodeficiency-associated Burkitt's lymphoma'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*The presentation of patients with immunodeficiency-related Burkitt's lymphoma is often accompanied by signs or symptoms related to the underlying immunodeficiency which can be the following:
**[[HIV AIDS|AIDS]]
**[[Primary immunodeficiency|Congenital immunodeficiency]]
**Acquired immunodeficiency due to bone marrow or solid [[Organ transplant|organ transplantation]]
*Immunodeficiency-related cases frequently often involve [[lymph nodes]], [[bone marrow]], and [[CNS]]
|}


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{Chromosomal abnormalities}}
{{Chromosomal abnormalities}}
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[[Category:Hematology]]
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[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Hematology]]
[[Category:Immunology]]

Latest revision as of 04:44, 18 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Overview

Burkitt's lymphoma may be classified according to the World Health Organization (WHO) classification into 3 clinical variants. The clinical variants are endemic Burkitt's lymphoma, sporadic Burkitt's lymphoma, and immunodeficiency-associated Burkitt's lymphoma.

Classification

Burkitt's lymphoma may be classified according to WHO classification into 3 clinical variants:

  • Endemic Burkitt's lymphoma [1]
  • Sporadic Burkitt's lymphoma[2]
  • Immunodeficiency-associated Burkitt's lymphoma[3]

It is almost impossible to differentiate these three clinical variants based on histology (i.e. microscopic appearance) or immunophenotype.

Classification Based on The Geographic Distribution and Clinical Presentation
Name Description
Endemic Burkitt's lymphoma

(African Burkitt's lymphoma)

Sporadic Burkitt's lymphoma

(Non-African or Non-endemic Burkitt's lymphoma)

Immunodeficiency-associated Burkitt's lymphoma
  • The presentation of patients with immunodeficiency-related Burkitt's lymphoma is often accompanied by signs or symptoms related to the underlying immunodeficiency which can be the following:
  • Immunodeficiency-related cases frequently often involve lymph nodes, bone marrow, and CNS

References

  1. Tao Q, Robertson KD, Manns A, Hildesheim A, Ambinder RF (1998). "Epstein-Barr virus (EBV) in endemic Burkitt's lymphoma: molecular analysis of primary tumor tissue". Blood. 91 (4): 1373–81. PMID 9454768.
  2. Ng JY, Thompson RJ, Lam A, Nigam S (2018). "Sporadic Burkitt's lymphoma masquerading as an intussuscepted Meckel's diverticulum in a 9-year-old child". BMJ Case Rep. 2018. doi:10.1136/bcr-2018-224333. PMID 30042102.
  3. Linke-Serinsöz E, Fend F, Quintanilla-Martinez L (2017). "Human immunodeficiency virus (HIV) and Epstein-Barr virus (EBV) related lymphomas, pathology view point". Semin Diagn Pathol. 34 (4): 352–363. doi:10.1053/j.semdp.2017.04.003. PMID 28506687.

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