BURKITT’s Lymphoma Flashcards
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.
malignant
lymphocytes
NHL; malignant; undifferentiated; high
non cleaved; B
______ is the fastest growing tumor in man
Burkitt’s lymphoma
BL was named after ____________, a British surgeon serving in the army in _________.
•l
Dennis Parsons Burkitt
Uganda
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.
jaw swelling
BL has a doubling time of ——- & a ____% growth potential.
24hrs
100
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
tropics
26.6
50
1500
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.
40
over half
INCIDENCE & PREVALENCE
• M:F; __:__ (more in _____)
•90% between ___-__yrs.
•Peaks at age ___.
2:1.
Males
4-9
5
AETIOPATHOGENESIS of BL
•______ infection
•_______ infection
•Chromosomal _______
•Malnutrition/Low socioeconomic factors.
EBV
Chronic malaria
translocation
TYPES of BL
•_________(________)
•___________(________)
•______ associated
Endemic; African
Sporadic
non-endemic
HIV
Differentiate between endemic or sporadic BL in terms of :
GEOGRAPHICAL LOCATN
Age
Site
Africa ; North America
Children; young adults
Extranodal ; nodal
Differentiate between endemic or sporadic BL in terms of :
Marrow involvement
EBV ANTIBDY&GENOME
IgM SECRETION
Translocation
Late; early
Present; absent
Negative ; positive
Recombinase mediated; isotope switch mediate
Differentiate between endemic or sporadic BL in terms of :
C-MYC GENE REARRANGMNT
LINK WITH MALARIA
SENSIT TO CYCLOPHOS
Absent; present
Present ; absent
High; relative
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
•_________
Painless; rapidly
jaw mass; 4wks
Halithosis
CLINICAL FEATURES of BL
•_____ bleeding
•______ swelling
•____________ of teeth
Gum
Gingival
Loosening
CLINICAL STAGING OF BL By ZEIGLER & MAGRATH 1974
Stage A
Stage B
Stage C
Stage D
Stage AR
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.
Laboratory investigations of BL
• Biopsy of lesion for histology reveals the _______ appearance.
• FNAC reveals ________
• CSF cytology.
• BMA.
starry-sky
Burkitt cells
Radiology of BL
X ray of the jaw reveals;
• Dental _______
• Loss of _______ of both erupted and unerupted teeth
•_______ bone ______.
anarchy
lamina dura
Osteolytic; lesions
TREATMENT of BL
• ______therapy
•______
• ______therapy
Chemo
Surgery
Radio
Chemotherapy
1ST Line (COM)
•—— ___________
•—— _________
•—— __________
•—— ___________
IV Cyclophosphamide
IV Vincristine
IV Methotrexate
IT Methotrexate
SUPPORTIVE TREATMENT
•Hydration; 2-3l/m2/day
•Allopurinol
•Paludrine
•Haematinics
•Antibiotics
•Antiemetics
COMPLICATIONS of BL Due to the disease;
•________,
• paraplegia,
• pathologic _______,
blindness
fracture
COMPLICATIONS of BL Due to the disease
• facial ______,
• bone marrow _______,
• intestinal ________
deformity
aplasia
obstruction
COMPLICATIONS of BL Due to the disease;
•______,
•_______ syndrome,
• ______
infertility
tumor lysis
ARF
PROGNOSIS of BL
WORSE PROGNOSIS:
• A (small or large?( tumor load
• Age ____yrs or _____yrs
• Male or female?)
• Relapse
• Stage _____ disease
•___________ type.
Large
<3; >14
Male
D; Leukemic
Burkitt’s lymphoma: The strength with which it poses threat to life is proportional to _________.
its responsiveness to chemotherapy
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.
