An update on Burkitt lymphoma: a review of pathogenesis and multimodality imaging assessment of disease presentation, treatment response, and recurrence

Abstract

Burkitt lymphoma (BL) is a highly aggressive, rapidly growing B cell non-Hodgkin lymphoma, which manifests in several subtypes including sporadic, endemic, and immunodeficiency-associated forms. Pathologically, BL is classically characterized by translocations of chromosomes 8 and 14 resulting in upregulation of the c-myc protein transcription factor with upregulation of cell proliferation. BL affects nearly every organ system, most commonly the abdomen and pelvis in the sporadic form. Imaging using a multimodality approach plays a crucial role in the management of BL from diagnosis, staging, and evaluation of treatment response to therapy-related complications with ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography playing roles. In this article, we review the pathobiology and classification of BL, illustrate a multimodality imaging approach in evaluating common and uncommon sites of involvement within the trunk and head and neck, and review common therapies and treatment-related complications.

Serine Biosynthesis Pathway Supports MYC–miR-494–EZH2 Feed-Forward Circuit Necessary to Maintain Metabolic and Epigenetic Reprogramming of Burkitt Lymphoma Cells

“…Its incidence decreases in older age groups, constituting 1-2% of NHL cases in adults [2][3][4]. It is estimated that 90% of children with BL are cured with intensive chemotherapy, albeit at the cost of considerable toxicity and treatment-related complications [5]. Despite relatively good prognosis for the majority of patients, treatment options for relapsed and refractory BL remain limited, and median overall survival in these cases usually does not exceed 3 months [5][6][7].…”

Isolated oculomotor nerve palsy as a manifestation of diffuse large B cell lymphoma: A case report

“…Almost all forms of Burkitt's lymphoma are identified with a MYC locus rearrangement (translocation at 8q24) that results in increased MYC protein levels, promoting cell proliferation (11). The Ki-67 staining pattern in such cases is usually >95% (15). In the current case, the Ki-67 staining pattern (80%) together with the IHC and FISH data confirmed the absence of MYC involvement, thus reducing the likelihood of the tumor being ascribed as a Burkitt's lymphoma.…”

“…A recent report identified only three cases of ONP as the Burkitt manifestation, occurring in patients with HIV infection (12). Burkitt's is rapidly fatal if left untreated but curable with intensive chemotherapy (doxorubicin, alkylators, vincristine and etoposide); however, it cannot be cured by the protocol used for DLBCL (15). Diagnostic accuracy is therefore essential to prevent mistreatment.…”

The snoring 2-year-old boy: a case of primary nasopharyngeal Burkitt’s lymphoma

“…MRI is being increasingly used in the evaluation of BL since it allows superior soft tissue characterisation and, therefore, improved assessment of tumour extension. PET combined with CT combines functional information with anatomic imaging and, therefore, allows a superior prediction of treatment response and recurrence 13…”