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Burkitt lymphoma (or "Burkitt's tumor", or "Malignant lymphoma, Burkitt's type") is a cancer of the lymphatic system (in particular, B lymphocytes). It is named after Denis Parsons Burkitt, a surgeon who first described the disease in 1956 while working in equatorial Africa.
Almost by definition, Burkitt lymphoma are associated with c-myc gene translocation. The most common variant is t(8;14)(q24;q32) while rarer variants include t(2;8)(p12;q24) and t(8;22)(q24;q11). A three-way translocation, t(8;14;18), has also been identified.
Currently Burkitt's lymphoma can be divided into three main clinical variants: the endemic, the sporadic and the immunodeficiency-associated variants.
By morphology (i.e. microscopic appearance) or immunophenotype, it is almost impossible to differentiate these three clinical variants. Immunodeficiency-associated Burkitt lymphoma may demonstrate more plasmacytic appearance or more pleomorphism, but these features are not specific.
Consists of sheets of monotonous (i.e. similar in size and morphology) population of medium size lymphoid cells with high proliferative activity and apoptotic activity. The "starry sky" appearance seen under low power is due to scattered tingible-bodies laden macrophages (macrophages containing dead body of apoptotic tumor cells). The old descriptive term of "small non-cleaved cell" is misleading. The tumor cells are mostly medium in size (i.e. tumor nuclei size similar to that of histiocytes or endothelial cells). "Small non-cleaved cells" are compared to "large non-cleaved cells" of normal germinal center lymphocytes. Tumor cells possess small amount of basophilic cytoplasm. The cellular outline usually appears squared off.
Malignant B cell characteristics
Normal B cells possess rearranged immunoglobulin heavy (IgH) and light chain genes, unlike most T-cells and other cells of the body in which the genes are germline. Each isolated B-cells possess a unique IgH gene rearrangement, reminiscent the fingerprint of a person. Readers are referred to other articles in Wikipedia for the mechanism of this diversity (e.g. immunoglobulin). Since Burkitt lymphoma and other B-cell lymphomas are clonal proliferative process, all tumor cells from one patient are supposed to possess identical IgH gene. When the DNA of tumor cells is analyzed using electrophoresis, a clonal band can be demonstrated since identical IgH gene will move to the same position. On the contrary, when a normal or reactive lymph node is analyzed using the same technique, a smear rather than a distinct band will be seen. This technique is useful since sometime benign reactive process (e.g. infectious mononucleosis) and malignant lymphoma can be difficult to distinct.
Effect of the chemotherapy, as with all cancers, depends on the time of diagnosis. With faster growing cancers, such as this one, the cancer actually responds faster than with slower growing cancers. This rapid response to chemotherapy can be hazardous to patient as a phenomenon so called "tumor lysis syndrome" could occur. Close monitoring of patient and adequate hydration is essential during the process.
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Burkitt's_lymphoma". A list of authors is available in Wikipedia.|