BURKITT’s Lymphoma

Question 1

Burkitt’s lymphoma

• A lymphoma is a (benign or malignant?) disease of blood _______.

It belongs to a category of (HL or NHL?) of the (benign or malignant?) (differentiated or undifferentiated ?) (low or high?) grade and small (cleaved or non cleaved?) cells mainly of (B or T?) cell origin.

Answer 1

malignant

lymphocytes

NHL; malignant; undifferentiated; high

non cleaved; B

Question 2

______ is the fastest growing tumor in man

Answer 2

Burkitt’s lymphoma

Question 3

BL was named after ____________, a British surgeon serving in the army in _________.
•l

Answer 3

Dennis Parsons Burkitt

Uganda

Question 4

Dennis Parsons Burkitt, noticed the first case in 1956 as a _______ in a 5 yr old boy,. He tried to treat the patient who eventually died after few wks. This led to his study of the condition, hence his publication in 1958.

Answer 4

jaw swelling

Question 5

BL has a doubling time of ——- & a ____% growth potential.

Answer 5

24hrs

100

Question 6

EPIDEMIOLOGY of BL

The disease occurs more in the _____;

• Areas around lat 10 ° N to 15 ° S of the equator.
• Temp not <____°C
• Annual rainfall not <___cm
• Altitude not >______m

Answer 6

tropics

26.6

50

1500

Question 7

INCIDENCE & PREVALENCE of BL

•BL accounts for ____% of all lymphoreticular tumours.
•
Studies in Africa indicates that it accounts for ________ of all malignant tumors in tropical Africa.

Answer 7

40

over half

Question 8

INCIDENCE & PREVALENCE

• M:F; __:__ (more in _____)

•90% between ___-__yrs.

•Peaks at age ___.

Answer 8

2:1.

Males

4-9

5

Question 9

AETIOPATHOGENESIS of BL

•______ infection
•_______ infection
•Chromosomal _______
•Malnutrition/Low socioeconomic factors.

Answer 9

EBV

Chronic malaria

translocation

Question 10

TYPES of BL

•_________(________)
•___________(________)
•______ associated

Answer 10

Endemic; African

Sporadic

non-endemic

HIV

Question 11

Differentiate between endemic or sporadic BL in terms of :

GEOGRAPHICAL LOCATN
Age
Site

Answer 11

Africa ; North America
Children; young adults
Extranodal ; nodal

Question 12

Differentiate between endemic or sporadic BL in terms of :

Marrow involvement

EBV ANTIBDY&GENOME

IgM SECRETION

Translocation

Answer 12

Late; early

Present; absent

Negative ; positive

Recombinase mediated; isotope switch mediate

Question 13

Differentiate between endemic or sporadic BL in terms of :

C-MYC GENE REARRANGMNT

LINK WITH MALARIA

SENSIT TO CYCLOPHOS

Answer 13

Absent; present

Present ; absent

High; relative

Question 14

CLINICAL FEATURES of BL

• (Painful or Painless?) (slowly or rapidly?) increasing ______ noticed within _____ of onset(70% of cases)

• Non specific symptoms; anorexia, fever and malaise could initially occur

•_________

Answer 14

Painless; rapidly

jaw mass; 4wks

Halithosis

Question 15

CLINICAL FEATURES of BL

•_____ bleeding
•______ swelling
•____________ of teeth

Answer 15

Gum

Gingival

Loosening

Question 16

CLINICAL STAGING OF BL By ZEIGLER & MAGRATH 1974

Stage A

Stage B

Stage C

Stage D

Stage AR

Answer 16

Single extra-abdominal mass(one quadrant of the face)

2 or more extra-abdominal mass(2 quadrant of d face)

Intra-abdominal mass with or without A OR B

Intra-abdominal mass with bone marrow or CNS involvement.

> 90% abdominal mass resectable.

Question 17

Laboratory investigations of BL

• Biopsy of lesion for histology reveals the _______ appearance.

• FNAC reveals ________

• CSF cytology.
• BMA.

Answer 17

starry-sky

Burkitt cells

Question 18

Radiology of BL
X ray of the jaw reveals;

• Dental _______
• Loss of _______ of both erupted and unerupted teeth
•_______ bone ______.

Answer 18

anarchy

lamina dura

Osteolytic; lesions

Question 19

TREATMENT of BL

• ______therapy
•______
• ______therapy

Answer 19

Chemo

Surgery

Radio

Question 20

Chemotherapy
1ST Line (COM)
•—— ___________
•—— _________
•—— __________
•—— ___________

Answer 20

IV Cyclophosphamide

IV Vincristine

IV Methotrexate

IT Methotrexate

Question 21

SUPPORTIVE TREATMENT
•Hydration; 2-3l/m2/day
•Allopurinol
•Paludrine
•Haematinics
•Antibiotics
•Antiemetics

Question 22

COMPLICATIONS of BL Due to the disease;

•________,
• paraplegia,
• pathologic _______,

Answer 22

blindness

fracture

Question 23

COMPLICATIONS of BL Due to the disease

• facial ______,
• bone marrow _______,
• intestinal ________

Answer 23

deformity

aplasia

obstruction

Question 24

COMPLICATIONS of BL Due to the disease;

•______,
•_______ syndrome,
• ______

Answer 24

infertility

tumor lysis

ARF

Question 25

PROGNOSIS of BL

WORSE PROGNOSIS:

• A (small or large?( tumor load
• Age ____yrs or _____yrs
• Male or female?)
• Relapse
• Stage _____ disease
•___________ type.

Answer 25

Large

<3; >14

Male

D; Leukemic

Question 26

Burkitt’s lymphoma: The strength with which it poses threat to life is proportional to _________.

Answer 26

its responsiveness to chemotherapy

Question 27

The strength with which it poses threat to life is proportional to its responsiveness to chemotherapy. Therefore, early diagnosis and treatment will strongly reduce the morbidity and mortality associated with this fastest growing tumor ever known to man.