Burkitts Lymphoma Flashcards
What are the to main types of lymphoma?
Non-hodgkins and Hodgkins
What is the commonest childhood cancer in tropical Africa?
Non-Hodgkins Lymphoma
What is the malignant solid tumor of B or T cell lymphocytes?
Non-Hodgkins lymphoma
Age range for non-hodgkins and peak age
4-9 years, peak 5 years
Rare age ranges for Non-Hodgkins lymphoma
<2years and >16years
Gender ratio of Non-hodgkins lymphoma?
Males:females
2:1
Favourable prognosis for NHL?
Minimal therapy in early stages
General symptoms for NHL?
No. Depends on location of tumor
Clinical presentation of NHL in the head and neck.
- Neck or jaw mass involving nasopharynx, sinuses-painless or painful
- Proptosis
- Dental anarchy
- Breathing or swallowing difficulty
Clinical presentation of NHL in the abdomen
- Abdominal mass +/- ascites
- Abdominal pain
- Nausea and vomiting, constipation +/- bowel obstruction
- Urinary retention
- Spinal cord compression- paraplegia
Clinical presentation of a T cell lymphoblastic lymphoma
- Cough, stridor, dyspnea +/- pleural effusion +/- SVC obstruction
- Hepatosplenomegaly
Features of Endemic type?
5-10 years
Male>female
Common in Africa, Brazil and Turkey
Jaw, abdomen, CNS, CSF
95% - Epstein Barr Virus
Rapidly growing tumor of the jaws or abdomen in high risk groups with doubling time of 24 hours.
Short duration of PC.
Features of Sporadic type
6-12 years
Male>female
Abdomen, bone marrow, lymph nodes, ovaries.
Diagnosis of endemic type
Biopsy for histology
😻 starry sky appearance
What are the sanctuary sites for Burkitts lymphoma?
Indication of poor prognosis
Testes
Breasts
Thyroid gland
Pancreas
Skin
Epidural space
Bone
What hematologic investigations will you do and what do you expect?
Full Blood Count - to rule out leukemia
Blood film comment
Renal and Liver Function tests
LDH( lactic acid dehydrogenase) - raised in Non-Hodgkins lymphoma
Uric acid- increased in high tumor burden
HIV test
What imaging investigations will I do?
Chest X-ray for mediastinal mass
Abdominal and /or neck ultrasound
CT scan / MRI
Echocardiogram- ejection fraction of doxorubicin administration.
Needle biopsy
Pleural or ascites fluid
Bone marrow aspirates + trephine for staging
Lumbar puncture- CNS status
Immunohistochemistry
What is stage A?
Single extrabdominal tumor site
Stage B?
Multiple extra abdominal site
Stage AR?
Completely (>90%) resected intraabdominal tumor.
Stage C?
Intraabdominal tumor without involvement of other sites
Stage D?
Intraabdominal and Extra abdominal tumor sites
Treatment
Cycle 1/Prephase
Oral medications with Cyclophosphamide, Prednisolone and Allupurinol
Alternate treatment cycle
Vincristine, Doxorubicin, Cyclophosphamide, prednisolone.
Intrathecal with
Cytarabine, vincristine, cyclophosphamide, prednisolone-
