Sections

Burkitt Lymphoma and Burkitt-like Lymphoma

Sections Burkitt Lymphoma and Burkitt-like Lymphoma
Overview
Presentation
DDx
Workup
Treatment
Guidelines
Medication
Questions & Answers
Media Gallery
References

DDx

Diagnostic Considerations

Burkitt lymphoma (BL) must be distinguished from other primary abdominal tumors in childhood, including Wilms tumor, neuroblastoma, and peripheral neuroectodermal tumor. In the bone marrow, BL must be differentiated from B and T precursor and myeloid leukemias. Among peripheral B-cell lymphomas, the major difficulty is to differentiate BL from diffuse large B-cell lymphoma (DLBCL), lymphoblastic lymphoma, and blastic mantle cell lymphoma (MCL).

DLBCL

DLBCL typically has larger cells, but some Burkitt lymphoma (BL) cases might have centroblast-like (large) cells intermixed with the more common medium-sized monoclonal lymphocytes, resulting in some degree of a diagnostic dilemma, especially when considering that up to 15% of DLBCL cases might test positive for the c-myc translocation. Those borderline cases are categorized under Burkitt-like lymphoma (BLL). In the 2008 World Health Organization (WHO) classification system, these are referred to as "B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma."^{[2, 45]}(See Histologic Features.)

Features that rule out the diagnosis of Burkitt lymphoma (BL) include bcl-6 gene rearrangement (independent from bcl-6 nuclear staining), bcl-2 positivity, presence of t(14;18), and a Ki67 staining of less than 95%.^{[46, 47]}

Researchers have been able to define a specific genetic signature for Burkitt lymphoma (BL). Two different studies explored gene-expression profiling by microarray technology as a tool to accurately diagnose Burkitt lymphoma (BL) and differentiate it from DLBCL due to the significant difference in prognosis and treatment approaches for these diseases.^{[48, 49]}Results showed that 17-34% of DLBCL cases diagnosed by expert pathologists had the typical Burkitt lymphoma (BL) genetic signature; likewise up to 4% of cases signed out as classic or atypical BL lacked the typical genetic signature.

In both studies, rare cases with the Burkitt signature were c-myc negative.^{[48, 49]}Moreover, patients with a Burkitt lymphoma (BL) signature who were treated with CHOP-like (cyclophosphamide, hydroxydaunorubicin hydrochloride [doxorubicin hydrochloride], vincristine and prednisone) regimens had a worse prognosis than those patients who were treated with more intense chemotherapy regimens.^{[48, 49]}Unfortunately, microarray analysis is not readily available in most clinical settings and remains a research tool.

Lymphoblastic and mantle cell lymphomas

Lymphoblastic lymphoma may be histologically similar to Burkitt lymphoma (BL), however, it is a T-cell lymphoma that expresses T-cell markers in addition to TdT, which are usually negative in BL cases. Similarly, mantle cell lymphoma cases can be easily distinguished from Burkitt lymphoma (BL) by immunohistochemistry and flow cytometry as they typically stain strongly for CD5 and cyclin D1, unlike BL.

Differential Diagnoses

Workup

Molyneux EM, Rochford R, Griffin B, Newton R, Jackson G, Menon G, et al. Burkitt's lymphoma. Lancet. 2012 Mar 31. 379 (9822):1234-44. [Medline].
Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016 May 19. 127 (20):2375-90. [Medline]. [Full Text].
Gong JZ, Stenzel TT, Bennett ER, et al. Burkitt lymphoma arising in organ transplant recipients: a clinicopathologic study of five cases. Am J Surg Pathol. 2003 Jun. 27(6):818-27. [Medline].
Husain M, Grunebaum E, Naqvi A, et al. Burkitt's lymphoma in a patient with adenosine deaminase deficiency-severe combined immunodeficiency treated with polyethylene glycol-adenosine deaminase. J Pediatr. 2007 Jul. 151(1):93-5. [Medline].
Ferry JA. Burkitt's lymphoma: clinicopathologic features and differential diagnosis. Oncologist. 2006 Apr. 11(4):375-83. [Medline].
Blum KA, Lozanski G, Byrd JC. Adult Burkitt leukemia and lymphoma. Blood. 2004 Nov 15. 104(10):3009-20. [Medline].
Burkitt DP. Classics in oncology. A sarcoma involving the jaws in African children. CA Cancer J Clin. 1972 Nov-Dec. 22(6):345-55. [Medline].
Burkitt D, O'Conor GT. Malignant lymphoma in African children. I. A clinical syndrome. Cancer. 1961 Mar-Apr. 14:258-69. [Medline].
Epstein MA, Achong BG, Barr YM. Virus particles in cultured lymphoblasts from Burkitt's lymphoma. Lancet. 1964 Mar 28. 1(7335):702-3. [Medline].
Magrath I. The pathogenesis of Burkitt's lymphoma. Adv Cancer Res. 1990. 55:133-270. [Medline].
Magrath IT. African Burkitt's lymphoma. History, biology, clinical features, and treatment. Am J Pediatr Hematol Oncol. 1991 Summer. 13(2):222-46. [Medline].
De Falco G, Antonicelli G, Onnis A, Lazzi S, Bellan C, Leoncini L. Role of EBV in microRNA dysregulation in Burkitt lymphoma. Semin Cancer Biol. 2009 Dec. 19(6):401-6. [Medline].
Thorley-Lawson DA, Allday MJ. The curious case of the tumour virus: 50 years of Burkitt's lymphoma. Nat Rev Microbiol. 2008 Dec. 6(12):913-24. [Medline].
Preudhomme C, Dervite I, Wattel E, et al. Clinical significance of p53 mutations in newly diagnosed Burkitt's lymphoma and acute lymphoblastic leukemia: a report of 48 cases. J Clin Oncol. 1995 Apr. 13(4):812-20. [Medline].
Gaidano G, Ballerini P, Gong JZ, et al. p53 mutations in human lymphoid malignancies: association with Burkitt lymphoma and chronic lymphocytic leukemia. Proc Natl Acad Sci U S A. 1991 Jun 15. 88(12):5413-7. [Medline]. [Full Text].
Dang CV, Resar LM, Emison E, et al. Function of the c-Myc oncogenic transcription factor. Exp Cell Res. 1999 Nov 25. 253(1):63-77. [Medline].
Dang CV, O'Donnell KA, Juopperi T. The great MYC escape in tumorigenesis. Cancer Cell. 2005 Sep. 8(3):177-8. [Medline].
Coller HA, Grandori C, Tamayo P, et al. Expression analysis with oligonucleotide microarrays reveals that MYC regulates genes involved in growth, cell cycle, signaling, and adhesion. Proc Natl Acad Sci U S A. 2000 Mar 28. 97(7):3260-5. [Medline]. [Full Text].
Molina-Privado I, Rodriguez-Martinez M, Rebollo P, et al. E2F1 expression is deregulated and plays an oncogenic role in sporadic Burkitt's lymphoma. Cancer Res. 2009 May 1. 69(9):4052-8. [Medline]. [Full Text].
Love C, Sun Z, Jima D, et al. The genetic landscape of mutations in Burkitt lymphoma. Nat Genet. 2012 Dec. 44 (12):1321-5. [Medline]. [Full Text].
Richter J, et al; ICGC MMML-Seq Project. Recurrent mutation of the ID3 gene in Burkitt lymphoma identified by integrated genome, exome and transcriptome sequencing. Nat Genet. 2012 Dec. 44 (12):1316-20. [Medline].
Davi F, Delecluse HJ, Guiet P, et al. Burkitt-like lymphomas in AIDS patients: characterization within a series of 103 human immunodeficiency virus-associated non-Hodgkin's lymphomas. Burkitt's Lymphoma Study Group. J Clin Oncol. 1998 Dec. 16(12):3788-95. [Medline].
Cardy HA, Sharp L, Little J. Burkitt's lymphoma: a review of the epidemiology. Kuwait Med J. 2001. 33:293-306.
Makata AM, Toriyama K, Kamidigo NO, Eto H, Itakura H. The pattern of pediatric solid malignant tumors in western Kenya, east Africa, 1979-1994: an analysis based on histopathologic study. Am J Trop Med Hyg. 1996 Apr. 54(4):343-7. [Medline].
Swerdlow SH, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th Edition. Lyon, France: International Agency for Research on Cancer; 2008.
Havelange V, Pepermans X, Ameye G, Théate I, Callet-Bauchu E, Barin C, et al. Genetic differences between paediatric and adult Burkitt lymphomas. Br J Haematol. 2016 Apr. 173 (1):137-44. [Medline].
Ladenstein R, Pearce R, Hartmann O, Patte C, Goldstone T, Philip T. High-dose chemotherapy with autologous bone marrow rescue in children with poor-risk Burkitt's lymphoma: a report from the European Lymphoma Bone Marrow Transplantation Registry. Blood. 1997 Oct 15. 90(8):2921-30. [Medline].
Thomas DA, Faderl S, O'Brien S, et al. Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. Cancer. 2006 Apr 1. 106(7):1569-80. [Medline].
Magrath I, Adde M, Shad A, et al. Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol. 1996 Mar. 14(3):925-34. [Medline].
Kantarjian HM, Walters RS, Keating MJ, et al. Results of the vincristine, doxorubicin, and dexamethasone regimen in adults with standard- and high-risk acute lymphocytic leukemia. J Clin Oncol. 1990 Jun. 8(6):994-1004. [Medline].
Ostronoff M, Soussain C, Zambon E, et al. Burkitt's lymphoma in adults: a retrospective study of 46 cases. Nouv Rev Fr Hematol. 1992. 34(5):389-97. [Medline].
Hoelzer D, Ludwig WD, Thiel E, et al. Improved outcome in adult B-cell acute lymphoblastic leukemia. Blood. 1996 Jan 15. 87(2):495-508. [Medline].
McMaster ML, Greer JP, Greco FA, Johnson DH, Wolff SN, Hainsworth JD. Effective treatment of small-noncleaved-cell lymphoma with high-intensity, brief-duration chemotherapy. J Clin Oncol. 1991 Jun. 9(6):941-6. [Medline].
Soussain C, Patte C, Ostronoff M, et al. Small noncleaved cell lymphoma and leukemia in adults. A retrospective study of 65 adults treated with the LMB pediatric protocols. Blood. 1995 Feb 1. 85(3):664-74. [Medline].
Tholouli E, Watt S, Lucas GS, et al. Stage IV adult sporadic Burkitt lymphoma/leukemia with complex bone marrow cytogenetics is associated with a very poor outcome. Blood. 2009 Jul 9. 114(2):485-6; author reply 486-7. [Medline].
Thomas DA, Cortes J, O'Brien S, et al. Hyper-CVAD program in Burkitt's-type adult acute lymphoblastic leukemia. J Clin Oncol. 1999 Aug. 17(8):2461-70. [Medline].
Castillo JJ, Winer ES, Olszewski AJ. Population-based prognostic factors for survival in patients with Burkitt lymphoma: An analysis from the Surveillance, Epidemiology, and End Results database. Cancer. 2013 Jul 30. [Medline].
Armitage JO, Weisenburger DD. New approach to classifying non-Hodgkin's lymphomas: clinical features of the major histologic subtypes. Non-Hodgkin's Lymphoma Classification Project. J Clin Oncol. 1998 Aug. 16(8):2780-95. [Medline].
Derinkuyu BE, Boyunağa Ö, Öztunalı Ç, Tekkeşin F, Damar Ç, Alımlı AG, et al. Imaging features of Burkitt lymphoma in pediatric patients. Diagn Interv Radiol. 2016 Jan-Feb. 22 (1):95-100. [Medline]. [Full Text].
Lee AC, Li CH. Burkitt Lymphoma Presenting as Acute Pancreatitis: Report of 3 Cases and Review of the Literature. J Pediatr Hematol Oncol. 2019 Oct 29. 21(5):515-20. [Medline].
Legault S, Couture C, Bourgault C, Bergeron S, Poirier P, Sénéchal M. Primary cardiac Burkitt-like lymphoma of the right atrium. Can J Cardiol. 2009 Mar. 25(3):163-5. [Medline]. [Full Text].
Gutierrez-Garcia L, Medina Ramos N, Garcia Rodriguez R, Barber MA, Arias MD, Garcia JA. Bilateral ovarian Burkitt's lymphoma. Eur J Gynaecol Oncol. 2009. 30(2):231-3. [Medline].
Okudaira T, Nagasaki A, Miyagi T, Taira T, Ohshima K, Takasu N. Intensive chemotherapy for a patient with primary cutaneous diffuse large B-cell lymphoma with Burkitt-like morphology. Intern Med. 2009. 48(6):475-8. [Medline].
Braziel RM, Arber DA, Slovak ML, et al. The Burkitt-like lymphomas: a Southwest Oncology Group study delineating phenotypic, genotypic, and clinical features. Blood. 2001 Jun 15. 97(12):3713-20. [Medline].
Kluin PM, Harris NL, Stein H, Leoncini L. B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. Swerdlow SH, Campo E, Harris NL, et al, eds. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th ed. Lyon, France: IARC Press; 2008. 265-7.
Dogan A, Bagdi E, Munson P, Isaacson PG. CD10 and BCL-6 expression in paraffin sections of normal lymphoid tissue and B-cell lymphomas. Am J Surg Pathol. 2000 Jun. 24(6):846-52. [Medline].
McClure RF, Remstein ED, Macon WR, Dewald GW, Habermann TM, Hoering A. Adult B-cell lymphomas with burkitt-like morphology are phenotypically and genotypically heterogeneous with aggressive clinical behavior. Am J Surg Pathol. 2005 Dec. 29(12):1652-60. [Medline].
Dave SS, Fu K, Wright GW, Lam LT, et al, for the Lymphoma/Leukemia Molecular Profiling Project. Molecular diagnosis of Burkitt's lymphoma. N Engl J Med. 2006 Jun 8. 354(23):2431-42. [Medline].
Hummel M, Bentink S, Berger H, et al, for the Molecular Mechanisms in Malignant Lymphomas Network Project of the Deutsche Krebshilfe. A biologic definition of Burkitt's lymphoma from transcriptional and genomic profiling. N Engl J Med. 2006 Jun 8. 354(23):2419-30. [Medline].
Burmeister T, Schwartz S, Horst HA, Rieder H, Gokbuget N, Hoelzer D, et al. Molecular heterogeneity of sporadic adult Burkitt-type leukemia/lymphoma as revealed by PCR and cytogenetics: correlation with morphology, immunology and clinical features. Leukemia. 2005 Aug. 19(8):1391-8. [Medline].
Küppers R, Klein U, Hansmann ML, Rajewsky K. Cellular origin of human B-cell lymphomas. N Engl J Med. 1999 Nov 11. 341(20):1520-9. [Medline].
Garcia CF, Weiss LM, Warnke RA. Small noncleaved cell lymphoma: an immunophenotypic study of 18 cases and comparison with large cell lymphoma. Hum Pathol. 1986 May. 17(5):454-61. [Medline].
Magrath IT, Janus C, Edwards BK, et al. An effective therapy for both undifferentiated (including Burkitt's) lymphomas and lymphoblastic lymphomas in children and young adults. Blood. 1984 May. 63(5):1102-11. [Medline].
Smeland S, Blystad AK, Kvaloy SO, et al. Treatment of Burkitt's/Burkitt-like lymphoma in adolescents and adults: a 20-year experience from the Norwegian Radium Hospital with the use of three successive regimens. Ann Oncol. 2004 Jul. 15(7):1072-8. [Medline].
Bishop PC, Rao VK, Wilson WH. Burkitt's lymphoma: molecular pathogenesis and treatment. Cancer Invest. 2000. 18(6):574-83. [Medline].
Todeschini G, Bonifacio M, Tecchio C, et al. Intensive short-term chemotherapy regimen induces high remission rate (over 90%) and event-free survival both in children and adult patients with advanced sporadic Burkitt lymphoma/leukemia. Am J Hematol. 2012 Jan. 87(1):22-5. [Medline].
Hill QA, Owen RG. CNS prophylaxis in lymphoma: who to target and what therapy to use. Blood Rev. 2006 Nov. 20(6):319-32. [Medline].
Mead GM, Barrans SL, Qian W, et al, for the UK National Cancer Research Institute Lymphoma Clinical Studies Group and the Australasian Leukaemia and Lymphoma Group. A prospective clinicopathologic study of dose-modified CODOX-M/IVAC in patients with sporadic Burkitt lymphoma defined using cytogenetic and immunophenotypic criteria (MRC/NCRI LY10 trial). Blood. 2008 Sep 15. 112(6):2248-60. [Medline]. [Full Text].
Lee EJ, Petroni GR, Schiffer CA, et al. Brief-duration high-intensity chemotherapy for patients with small noncleaved-cell lymphoma or FAB L3 acute lymphocytic leukemia: results of cancer and leukemia group B study 9251. J Clin Oncol. 2001 Oct 15. 19(20):4014-22. [Medline].
Rizzieri DA, Johnson JL, Niedzwiecki D, et al. Intensive chemotherapy with and without cranial radiation for Burkitt leukemia and lymphoma: final results of Cancer and Leukemia Group B Study 9251. Cancer. 2004 Apr 1. 100(7):1438-48. [Medline].
Oriol A, Ribera JM, Bergua J, et al. High-dose chemotherapy and immunotherapy in adult Burkitt lymphoma: comparison of results in human immunodeficiency virus-infected and noninfected patients. Cancer. 2008 Jul 1. 113(1):117-25. [Medline].
Dunleavy K, Pittaluga S, Janik J, et al. Novel treatment of Burkitt lymphoma with dose-adjusted EPOCH-rituximab: Preliminary results showing excellent outcome (abstract). Blood. 2006. 108:774A.
Sweetenham JW, Pearce R, Taghipour G, Blaise D, Gisselbrecht C, Goldstone AH. Adult Burkitt's and Burkitt-like non-Hodgkin's lymphoma--outcome for patients treated with high-dose therapy and autologous stem-cell transplantation in first remission or at relapse... J Clin Oncol. 1996 Sep. 14(9):2465-72. [Medline].
Song KW, Barnett MJ, Gascoyne RD, et al. Haematopoietic stem cell transplantation as primary therapy of sporadic adult Burkitt lymphoma. Br J Haematol. 2006 Jun. 133(6):634-7. [Medline].
Philip T, Biron P. High-dose chemotherapy and autologous bone marrow transplantation in diffuse intermediate- and high-grade non-Hodgkin lymphoma. Crit Rev Oncol Hematol. 2002 Feb. 41(2):213-23. [Medline].
Nademanee A, Molina A, O'Donnell MR, et al. Results of high-dose therapy and autologous bone marrow/stem cell transplantation during remission in poor-risk intermediate- and high-grade lymphoma: international index high and high-intermediate risk group. Blood. 1997 Nov 15. 90(10):3844-52. [Medline].
Philip T, Armitage JO, Spitzer G, et al. High-dose therapy and autologous bone marrow transplantation after failure of conventional chemotherapy in adults with intermediate-grade or high-grade non-Hodgkin's lymphoma. N Engl J Med. Jun 11 1987. 316(24):1493-8. [Medline].
Grigg AP, Seymour JF. Graft versus Burkitt's lymphoma effect after allogeneic marrow transplantation. Leuk Lymphoma. 2002 Apr. 43(4):889-92. [Medline].
Peniket AJ, Ruiz de Elvira MC, Taghipour G, et al, for the European Bone Marrow Transplantation (EBMT) Lymphoma Registry. An EBMT registry matched study of allogeneic stem cell transplants for lymphoma: allogeneic transplantation is associated with a lower relapse rate but a higher procedure-related mortality rate than autologous transplantation. Bone Marrow Transplant. 2003 Apr. 31(8):667-78. [Medline].
Weinthal JA, Goldman SC, Lenarsky C. Successful treatment of relapsed Burkitt's lymphoma using unrelated cord blood transplantation as consolidation therapy. Bone Marrow Transplant. 2000 Jun. 25(12):1311-3. [Medline].
National Cancer Institute sponsored study of classifications of non-Hodgkin's lymphomas: summary and description of a working formulation for clinical usage. The Non-Hodgkin's Lymphoma Pathologic Classification Project. Cancer. 1982 May 15. 49 (10):2112-35. [Medline].
Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, et al. A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood. 1994 Sep 1. 84 (5):1361-92. [Medline]. [Full Text].
[Guideline] NCCN Clinical Practice Guidelines in Oncology. B-Cell Lymphomas. National Comprehensive Cancer Network. Available at https://www.nccn.org/professionals/physician_gls/pdf/b-cell.pdf. Version 6.2019 — November 26, 2019; Accessed: December 2, 2019.
Castillo JJ, Winer ES, Olszewski AJ. Population-based prognostic factors for survival in patients with Burkitt lymphoma: an analysis from the Surveillance, Epidemiology, and End Results database. Cancer. 2013 Oct 15. 119 (20):3672-9. [Medline].
Boerma EG, van Imhoff GW, Appel IM, Veeger NJ, Kluin PM, Kluin-Nelemans JC. Gender and age-related differences in Burkitt lymphoma--epidemiological and clinical data from The Netherlands. Eur J Cancer. 2004 Dec. 40(18):2781-7. [Medline].
Dunleavy K, Pittaluga S, Shovlin M, Steinberg SM, Cole D, Grant C, et al. Low-intensity therapy in adults with Burkitt's lymphoma. N Engl J Med. 2013 Nov 14. 369(20):1915-25. [Medline].
Osterweil N. Burkitt's Yields to Longer-Duration, Lower-Dose Chemo. Medscape Medical News. Available at http://www.medscape.com/viewarticle/814558. Accessed: November 26, 2013.

Media Gallery

Computed tomography scan in a patient with a large, left-sided axillary mass from which a biopsy was obtained. Biopsy findings were consistent with small noncleaved cell non-Hodgkin lymphoma.
Postchemotherapy computed tomography scan in a patient diagnosed with small noncleaved cell lymphoma (SNCCL) (same patient as in previous image). This image shows regression of a left axillary mass.
Coronal magnetic resonance imaging (MRI) section in a patient with large neck mass (same patient as in previous image). Biopsy findings showed Burkitt-like non-Hodgkin lymphoma (NHL). MRI was performed to assess for cord involvement.
Sagittal magnetic resonance imaging (MRI) section of the neck area showing a large mass invading the cervical spine with epidural encroachment (same patient as in the previous image). MRI was performed to rule out cord compression. The first image shows the gallium scan of this patient that correlates with the site of the tumor.
Right-sided pleural effusion in a patient with small noncleaved cell lymphoma (SNCCL) non-Hodgkin lymphoma.
Hematoxylin and eosin (H&E) stain. Sheets of monotonous-appearing lymphoid cells with one or more prominent nucleoli and an area of pale staining resulting from the presence of benign macrophages reveal a starry sky pattern.
The 2-dimensional flow cytometry demonstrates the highlighted cells to be CD5 negative and CD23 negative as well as lambda negative. Small noncleaved cell lymphoma (SNCCL) cells are typically CD19+, CD20+, CD22+, and CD10+.

of 7

Author

Ali H Kanbar, MD Medical Oncologist/Hematologist, Dayton Cancer Center

Ali H Kanbar, MD is a member of the following medical societies: American College of Physicians, American Society of Hematology, American Society of Clinical Oncology

Disclosure: Nothing to disclose.

Coauthor(s)

Ronald A Sacher, MBBCh, FRCPC, DTM&H Professor of Internal Medicine and Pathology, Director, Hoxworth Blood Center, University of Cincinnati Academic Health Center

Ronald A Sacher, MBBCh, FRCPC, DTM&H is a member of the following medical societies: American Association for the Advancement of Science, American Association of Blood Banks, American Clinical and Climatological Association, American Society for Clinical Pathology, American Society of Hematology, College of American Pathologists, International Society of Blood Transfusion, International Society on Thrombosis and Haemostasis, Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Chief Editor

Emmanuel C Besa, MD Professor Emeritus, Department of Medicine, Division of Hematologic Malignancies and Hematopoietic Stem Cell Transplantation, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American Society of Clinical Oncology, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Hematology, New York Academy of Sciences

Disclosure: Nothing to disclose.

Acknowledgements

Patturajah Anbumani, MD, MBBS, MS, MCh Associate Medical Director, Best Medical Care; Former Associate Medical Director, Jeanes Hospital, Temple University Health System; Former Adjunct Clinical Assistant Professor, New York College of Osteopathic Medicine; Former Clinical Assistant Professor, Department of Medicine, State University of New York-Downstate

Patturajah Anbumani, MD, MBBS, MS, MCh is a member of the following medical societies: American College of Physicians, American Medical Association, and American Medical Women’s Association

Disclosure: Nothing to disclose.

Samer A Bleibel, MD Staff Physician, Department of Internal Medicine, Wayne State University School of Medicine, St John's Hospital and Medical Centers

Samer A Bleibel, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Asher A Chanan-Khan, MD Assistant Professor, Department of Medicine, Division of Lymphoma and Bone Marrow Transplantation, Roswell Park Cancer Institute, State University of New York at Buffalo

Asher A Chanan-Khan, MD is a member of the following medical societies: American College of Physicians, American Medical Association, and American Society of Hematology

Disclosure: Nothing to disclose.

Hanxian Huang, MD, PhD Staff Physician, Department of Internal Medicine, Leesburg Regional Medical Center, The Villages Regional Hospital

Hanxian Huang, MD, PhD is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine

Disclosure: Nothing to disclose.

Anand B Karnad, MBBS Program Director, Fellowship Programs in Hematology-Oncology, Professor of Medicine, Division of Medical Oncology, Department of Medicine, University of Texas Health Sciences Center, San Antonio

Anand B Karnad, MBBS is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Osler Society, American Society of Hematology, Assocation of Subspecialty Professors, and Massachusetts Medical Society

Disclosure: Nothing to disclose.

Olga Kozyreva, MD Attending Physician, Division of Hematology-Oncology, St Elizabeth's Medical Center; Assistant Professor, Tufts University School of Medicine

Disclosure: Nothing to disclose.

Sarah K May, MD Consulting Staff, Department of Hematology-Oncology, Caritas Carney Hospital, Commonwealth Hematology-Oncology PC

Disclosure: Nothing to disclose.

from Memorial Sloan-Kettering - Philip Schulman, MD Chief, Medical Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center; Clinical Professor, Department of Medicine, New York University School of Medicine

Philip Schulman, MD is a member of the following medical societies: American Association for Cancer Research, American College of Physicians, American Society of Hematology, and Medical Society of the State of New York

Disclosure: Nothing to disclose.

Karen Seiter, MD Professor, Department of Internal Medicine, Division of Oncology/Hematology, New York Medical College

Karen Seiter, MD is a member of the following medical societies: American Association for Cancer Research, American College of Physicians, and American Society of Hematology

Disclosure: Novartis Honoraria Speaking and teaching; Schering Honoraria Speaking and teaching; Cephalon Honoraria Speaking and teaching; Celgene Honoraria Speaking and teaching

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Yubao Wang, MD, PhD Fellow, Division of Hematology/Medical Oncology, University of Texas Health Science Center, San Antonio

Yubao Wang, MD, PhD is a member of the following medical societies: American College of Physicians, American Society of Clinical Oncology, and American Society of Hematology

Disclosure: Nothing to disclose.

Sections Burkitt Lymphoma and Burkitt-like Lymphoma
Overview
Presentation
DDx
Workup
Treatment
Guidelines
Medication
Questions & Answers
Media Gallery
References

Burkitt Lymphoma and Burkitt-like Lymphoma Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

References

Tables

Contributor Information and Disclosures

What would you like to print?