Paediatric Imaging

Burkitt's lymphoma

(Denis P. Burkitt, 20th century, British physician in Uganda), Burkitt's lymphoma is of 2 types:

  • B-cell lymphoma endemic in parts of Africa and Papua New Guinea where there is a high incidence of malaria. It is associated with the Epstein Barr virus. The Epstein Barr virus, which causes infective mononucleosis, is very common and it is possible that malaria depresses the immunity, exposure to the virus in infancy producing the disorder.
  • African Burkitt's lymphoma involves the face, particularly the jaw and maxilla, producing facial disfigurement, the abdomen, especially ovaries and kidneys, and the retroperitoneal region. Lymphadenopathy is not a feature. The age of onset is earlier than the non-African variety, being about 7 years, with a range from 2-16 years with a peak of 4-6 years and a male preponderance. Non-African Burkitt's lymphoma most frequently presents as an abdominal tumour because of its predilection for the gastrointestinal tract (Fig.1), (Fig.2). Imaging by all modalities shows a solid mass lesion. Intestinal obstruction and on occasion renal obstruction may be present. Ascites, pleural effusion and CNS involvement are well described, the CNS involvement being meningeal. It is associated with Epstein Barr virus, in about 25% of patients. Peak onset is later than African Burkitt's at around 11 years. The prognosis is good.

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    Fig.1

    Burkitt's lymphoma involving the stomach. Filling defects are seen in the contrast-filled stomach with irregularity of the lesser curve.
    Burkitt's lymphoma, Fig.1
    Burkitt's lymphoma, Fig.2