Burkitt's lymphoma diagnostic study of choice: Difference between revisions

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Latest revision as of 23:07, 18 January 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: , Kamal Akbar, M.D.[2]

Overview

In Burkitts lymphoma tissue biopsy remains the preferred diagnostic study of choice. The biopsy will yield confirmatory results when histopathological and immunohistochemical techniques are used.

Diagnostic Study of Choice

Biopsy of the affected lymph nodes remains to be the diagnostic study of choice which confirms Burkitts lymphoma.

Study of choice

Lymph node or extra nodal tissue biopsy is diagnostic of Burkitt's lymphoma.
To view the characteristic findings of Burkitt's lymphoma biopsy please click here.

Staging

According to the Murphy staging system, there are four stages of Burkitt's lymphoma based on the number of nodes involved and the extra nodal spread.

Staging for Burkitt's lymphoma is provided in the following table:^[1]

**Murphy staging system**
Stage	Features
Stage I	Single nodal or extra nodal site involvement excluding mediastinum or abdomen^[2]
Stage II	Single extra nodal tumor with regional nodal involvement Two extra nodal tumors on one side of diaphragm^[2] Primary gastrointestinal tumor with or without associated mesenteric nodes Two or more nodal areas on one side of diaphragm
Stage IIR	Completely resected intra-abdominal disease
Stage III	Two single extra nodal tumors on opposite sides of diaphragm ^[2] All primary intra thoracic tumors All paraspinal or epidural tumors All extensive primary intra-abdominal disease Two or more nodal areas on opposite sides of diaphragm
Stage IIIA	Localized, non-resectable abdominal disease
Stage IIIB	Widespread multi organ abdominal disease
Stage IV	Initial CNS or bone marrow involvement (< 25%)

Diagnostic results

The following finding(s) on performing biopsy and FISH are confirmatory for Burkitts lymphoma :

C-MYC (FISH)^[3]
Starry-sky pattern (histopathological specimen)^[4]

References

↑ Perkins AS, Friedberg JW (2008). "Burkitt lymphoma in adults". Hematology Am Soc Hematol Educ Program: 341–8. doi:10.1182/asheducation-2008.1.341. PMID 19074108.
↑ ^2.0 ^2.1 ^2.2 Sandlund JT (2012). "Burkitt lymphoma: staging and response evaluation". Br J Haematol. 156 (6): 761–5. doi:10.1111/j.1365-2141.2012.09026.x. PMC 3292702. PMID 22296338.
↑ Aquino G, Marra L, Cantile M, De Chiara A, Liguori G, Curcio MP; et al. (2013). "MYC chromosomal aberration in differential diagnosis between Burkitt and other aggressive lymphomas". Infect Agent Cancer. 8 (1): 37. doi:10.1186/1750-9378-8-37. PMC 3850004. PMID 24079473.
↑ Andrade-Filho Jde S (2014). "Analogies in medicine: starry-sky appearance". Rev Inst Med Trop Sao Paulo. 56 (6): 541–2. PMC 4296877. PMID 25351551.

Template:WH Template:WS

[pmid19074108-1] Perkins AS, Friedberg JW (2008). "Burkitt lymphoma in adults". Hematology Am Soc Hematol Educ Program: 341–8. doi:10.1182/asheducation-2008.1.341. PMID 19074108.

[pmid22296338-2] 2.0 ^2.1 ^2.2 Sandlund JT (2012). "Burkitt lymphoma: staging and response evaluation". Br J Haematol. 156 (6): 761–5. doi:10.1111/j.1365-2141.2012.09026.x. PMC 3292702. PMID 22296338.

[pmid24079473-3] Aquino G, Marra L, Cantile M, De Chiara A, Liguori G, Curcio MP; et al. (2013). "MYC chromosomal aberration in differential diagnosis between Burkitt and other aggressive lymphomas". Infect Agent Cancer. 8 (1): 37. doi:10.1186/1750-9378-8-37. PMC 3850004. PMID 24079473.

[pmid25351551-4] Andrade-Filho Jde S (2014). "Analogies in medicine: starry-sky appearance". Rev Inst Med Trop Sao Paulo. 56 (6): 541–2. PMC 4296877. PMID 25351551.

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[2]

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@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Burkitt's lymphoma}}
-{{CMG}}; {{AE}}
+{{CMG}}; {{AE}}, {{kakbar}}
 == Overview ==
+In Burkitts lymphoma [[Biopsy|tissue biopsy]] remains the preferred diagnostic study of choice. The [[biopsy]] will yield confirmatory results when [[histopathological]] and [[immunohistochemical]] techniques are used.
 == Diagnostic Study of Choice ==
-Biopsy of the affected lymph nodes remains to be the diagnostic study of choice which confirms Burkitts lymphoma.
+Biopsy of the affected [[lymph nodes]] remains to be the diagnostic study of choice which confirms Burkitts lymphoma.
 === Study of choice ===
-* Lymph node or extra nodal tissue biopsy is diagnostic of Burkitt's lymphoma.
+* [[Lymph node]] or extra nodal tissue [[biopsy]] is diagnostic of Burkitt's lymphoma.
 * To view the characteristic findings of Burkitt's lymphoma biopsy please click [[Burkitt's lymphoma pathophysiology #Microscopic Pathology|'''here''']].
 ==Staging==
-According to the Murphy staging system, there are four stages of Burkitt's lymphoma based on the number of nodes involved and the extra nodal spread.
+According to the Murphy staging system, there are four stages of Burkitt's lymphoma based on the number of [[Lymph node|nodes]] involved and the extra nodal spread.
 Staging for Burkitt's lymphoma is provided in the following table:<ref name="pmid19074108">{{cite journal| author=Perkins AS, Friedberg JW| title=Burkitt lymphoma in adults. | journal=Hematology Am Soc Hematol Educ Program | year= 2008 | volume=  | issue=  | pages= 341-8 | pmid=19074108 | doi=10.1182/asheducation-2008.1.341 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19074108  }} </ref>
-{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
+{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
 |+ '''Murphy staging system'''
 ! style="background: #4479BA; color:#FFF;" | Stage
@@ Line 21: / Line 21: @@
 | style="padding: 5px 5px; background: #F5F5F5;" | Stage I
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* Single nodal or extra nodal site involvement excluding mediastinum or abdomen<ref name="pmid22296338">{{cite journal| author=Sandlund JT| title=Burkitt lymphoma: staging and response evaluation. | journal=Br J Haematol | year= 2012 | volume= 156 | issue= 6 | pages= 761-5 | pmid=22296338 | doi=10.1111/j.1365-2141.2012.09026.x | pmc=3292702 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22296338  }} </ref>
+* Single [[Lymph node|nodal]] or extra nodal site involvement excluding [[mediastinum]] or [[abdomen]]<ref name="pmid22296338">{{cite journal| author=Sandlund JT| title=Burkitt lymphoma: staging and response evaluation. | journal=Br J Haematol | year= 2012 | volume= 156 | issue= 6 | pages= 761-5 | pmid=22296338 | doi=10.1111/j.1365-2141.2012.09026.x | pmc=3292702 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22296338  }} </ref>
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" | Stage II
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* Single extra nodal tumor with regional nodal involvement
+* Single extra nodal [[tumor]] with regional nodal involvement
-* Two extra nodal tumors on one side of diaphragm<ref name="pmid22296338">{{cite journal| author=Sandlund JT| title=Burkitt lymphoma: staging and response evaluation. | journal=Br J Haematol | year= 2012 | volume= 156 | issue= 6 | pages= 761-5 | pmid=22296338 | doi=10.1111/j.1365-2141.2012.09026.x | pmc=3292702 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22296338  }} </ref>
+* Two extra nodal [[Tumor|tumors]] on one side of [[Thoracic diaphragm|diaphragm]]<ref name="pmid22296338">{{cite journal| author=Sandlund JT| title=Burkitt lymphoma: staging and response evaluation. | journal=Br J Haematol | year= 2012 | volume= 156 | issue= 6 | pages= 761-5 | pmid=22296338 | doi=10.1111/j.1365-2141.2012.09026.x | pmc=3292702 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22296338  }} </ref>
-* Primary gastrointestinal tumor with or without associated mesenteric nodes
+* Primary [[Gastrointestinal tract|gastrointestinal]] [[tumor]] with or without associated [[Mesentery|mesenteric]] nodes
-* Two or more nodal areas on one side of diaphragm
+* Two or more nodal areas on one side of [[diaphragm]]
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" | Stage IIR
@@ Line 36: / Line 36: @@
 | style="padding: 5px 5px; background: #F5F5F5;" | Stage III
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* Two single extra nodal tumors on opposite sides of diaphragm <ref name="pmid22296338">{{cite journal| author=Sandlund JT| title=Burkitt lymphoma: staging and response evaluation. | journal=Br J Haematol | year= 2012 | volume= 156 | issue= 6 | pages= 761-5 | pmid=22296338 | doi=10.1111/j.1365-2141.2012.09026.x | pmc=3292702 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22296338  }} </ref>
+* Two single extra nodal [[tumors]] on opposite sides of [[diaphragm]] <ref name="pmid22296338">{{cite journal| author=Sandlund JT| title=Burkitt lymphoma: staging and response evaluation. | journal=Br J Haematol | year= 2012 | volume= 156 | issue= 6 | pages= 761-5 | pmid=22296338 | doi=10.1111/j.1365-2141.2012.09026.x | pmc=3292702 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22296338  }} </ref>
-* All primary intra thoracic tumors
+* All primary intra thoracic [[tumors]]
-* All paraspinal or epidural tumors
+* All paraspinal or [[epidural]] [[tumors]]
 * All extensive primary intra-abdominal disease
-* Two or more nodal areas on opposite sides of diaphragm
+* Two or more nodal areas on opposite sides of [[diaphragm]]
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" | Stage IIIA
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* Localized, non-resectable abdominal disease
+* Localized, non-resectable [[abdominal]] disease
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" | Stage IIIB
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* Widespread multi organ abdominal disease
+* Widespread multi organ [[abdominal]] disease
 |-
 | style="padding: 5px 5px; background: #F5F5F5;" | Stage IV
 | style="padding: 5px 5px; background: #F5F5F5;" |
-* Initial CNS or bone marrow involvement (< 25%)
+* Initial [[CNS]] or [[bone marrow]] involvement (< 25%)
 |}
 ===== Diagnostic results =====
-The following finding(s) on performing biopsy and FISH are confirmatory for Burkitts lymphoma :
+The following finding(s) on performing biopsy and [[Fluorescence in situ hybridization|FISH]] are confirmatory for Burkitts lymphoma :
-* MYC-IGH (FISH)<ref name="pmid24079473">{{cite journal| author=Aquino G, Marra L, Cantile M, De Chiara A, Liguori G, Curcio MP et al.| title=MYC chromosomal aberration in differential diagnosis between Burkitt and other aggressive lymphomas. | journal=Infect Agent Cancer | year= 2013 | volume= 8 | issue= 1 | pages= 37 | pmid=24079473 | doi=10.1186/1750-9378-8-37 | pmc=3850004 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24079473  }} </ref>
+* [[Myc|C-MYC]] ([[Fluorescence in situ hybridization|FISH]])<ref name="pmid24079473">{{cite journal| author=Aquino G, Marra L, Cantile M, De Chiara A, Liguori G, Curcio MP et al.| title=MYC chromosomal aberration in differential diagnosis between Burkitt and other aggressive lymphomas. | journal=Infect Agent Cancer | year= 2013 | volume= 8 | issue= 1 | pages= 37 | pmid=24079473 | doi=10.1186/1750-9378-8-37 | pmc=3850004 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24079473  }} </ref>
-* Starry-sky pattern (histopathological specimen)<ref name="pmid25351551">{{cite journal| author=Andrade-Filho Jde S| title=Analogies in medicine: starry-sky appearance. | journal=Rev Inst Med Trop Sao Paulo | year= 2014 | volume= 56 | issue= 6 | pages= 541-2 | pmid=25351551 | doi= | pmc=4296877 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25351551  }} </ref>
+* Starry-sky pattern ([[histopathological]] specimen)<ref name="pmid25351551">{{cite journal| author=Andrade-Filho Jde S| title=Analogies in medicine: starry-sky appearance. | journal=Rev Inst Med Trop Sao Paulo | year= 2014 | volume= 56 | issue= 6 | pages= 541-2 | pmid=25351551 | doi= | pmc=4296877 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25351551  }} </ref>
 ==References==