Olivia Reitsma (13146042)
GNK 286, Case study 5
Burkitt’s Lymphoma was first described by Dr Denis Burkitt, who described the neoplasm in Ugandan children in 1957. 1,2 This report will cover the findings of a patient with a diagnosis of Burkitt Lymphoma, including the clinical presentation, disease history, treatment options and prognosis of the disease.
Burkitt Lymphoma can be described as a neoplasia of B cells that grows mainly in the jaw and sometimes also in the ovary and testis. Burkitt Lymphoma is a high grade Non-Hodgkin’s Lymphoma, histologically characterised by a mass of diffuse small non-cleaved B cell lymphocytes. 2 It usually presents in extranodal sites and has a very high proliferative rate. 2 It has…show more content… • Extradural lesion causing compression of the spinal cord.
• However, the child’s general condition is usually remarkably good. 2
To diagnose Burkitt Lymphoma, a fine needle aspiration cytology of the mass or excision biopsy for histology is needed to confirm diagnosis.2
Cells are fairly uniform in size, with rounded nuclei with granular nuclear chromatin, as well as a thin rim of basophilic cytoplasm. Vacuoles usually are present. The nucleus is slightly indented and has 2-5 nucleoli. 2
The distinctive ‘Starry Sky’ appearance is seen histologically with hematoxylin and eosin staining. 3 This pattern is made up of sheets of oval, monomorphic cells with large nuclei and multiple small nucleoli. These cells have a dark lilac cytoplasm, and a high mitotic activity. These cell are interspersed in-between macrophage debris, giving the typical ‘Starry Sky’ appearance. 3
The laboratory results of the Case Study shows typical endemic Burkitt’s Lymphoma:
First laboratory…show more content… 2
Supportive therapy will include the active prevention of tumour lysis syndrome, as well as sufficient hydration and Allopurinol at a daily dose of 10-20mg/kg.2
The mainstay of definitive treatment is chemotherapy, as the tumour is highly chemo sensitive. Cyclophosphamide is administered in a dose pf at least 1 g/m2 , together with a high or intermediate dose methotrexate. The chemotherapy is ‘short duration, high intensity’-treatment and, combined with CNS prophylaxis, shows excellent survival rates in children.2
Generally patients have a good prognosis. With modern chemotherapy, 85-100% of patients diagnosed in an early stage of the disease and 75-85% diagnosed in an advanced stage survive for 3 years. If there is no relapse after a year of chemotherapy, the patient has a 90% chance of indefinite survival. Therefore, Burkitt’s Lymphoma is a curable