Burkitt's lymphoma

Burkitt's lymphoma is a high-grade B-cell neoplasm. There are two major forms:
endemic (African) form: typically involves maxilla or mandible
sporadic form: abdominal (e.g. ileo-caecal) tumours are the most common form. More common in patients with HIV

Burkitt's lymphoma is associated with the c-myc gene translocation, usually t(8:14). The Epstein-Barr virus (EBV) is strongly implicated in the development of the African form of Burkitt's lymphoma and to a lesser extent the sporadic form.

Microscopy findings
'starry sky' appearance: lymphocyte sheets interspersed with macrophages containing dead apoptotic tumour cells

Management is with chemotherapy. This tends to produce a rapid response which may cause tumour lysis syndrome. Rasburicase (a recombinant version of urate oxidase, an enzyme which catalyses the conversion of uric acid to allantoin*) is often given before the chemotherapy to reduce the risk of this occurring.

*allantoin is 5-10 times more soluble than uric acid, so renal excretion is more effective

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