Malignant Tumors
Burkitt Lymphoma
aka BL
Highly aggressive B-cell non-Hodgkin lymphoma driven by MYC translocation; jaw involvement is characteristic in the African endemic form.
§ figuresFigures (4)
Fig. 1Burkitt lymphoma, touch prep, Wright stain
“Burkitt lymphoma, touch prep, Wright stain” · Ed Uthman, MD. · CC BY 2.0 · Wikimedia Commons
Fig. 2ID#: 6050 Description: This Nigerian child presented with a large facial tumor due to malignant Burkitt’s lymphoma, a non-Hodgkin’s lymphoma (NHL). Very similar to leukemia, Burkitt’s lymphoma is a very aggressive, malig
“Malignant Burkitt’s lymphoma, a non-Hodgkin’s lymphoma (NHL) 064 lores” · Wikimedia Commons contributor · Public domain · Wikimedia Commons
Fig. 3Facial Burkitt's lymphoma in 7-year-old Nigerian boy, showing disruption of teeth and partial obstruction of airway
“Burkitt's lymphoma” · Mike Blyth · CC BY-SA 2.5 · Wikimedia Commons
Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Burkitt Lymphoma figures pending faculty review.
§ overviewOverview
Aggressive mature B-cell lymphoma defined by the t(8;14) MYC translocation (variants t(2;8), t(8;22)).
§ icdICD Classification
C83.7
§ etiologyEtiology
- 01Endemic form: EBV + Plasmodium falciparum co-infection
- 02Sporadic: unknown
- 03Immunodeficiency: HIV/AIDS-associated
§ epidemiologyEpidemiology
Endemic — equatorial Africa, children 4–7y, jaw mass in 50–70%. Sporadic — worldwide, ileocaecal.
§ pathogenesisPathogenesis
MYC translocation places MYC oncogene under IGH enhancer → constitutive proliferation; near-100% Ki-67 index; doubling time ≈ 24 h.
§ clinicalClinical Features
- 01Rapidly enlarging, painless jaw swelling (posterior maxilla most common)
- 02Loose teeth, ill-fitting appliances
- 03Facial deformity, proptosis
- 04B symptoms uncommon
- 05Extranodal: kidneys, ovaries, CNS
§ differentialDifferential Diagnosis
- 01Osteosarcoma
- 02Ewing sarcoma
- 03Odontogenic abscess
- 04Ameloblastoma
- 05Rhabdomyosarcoma
§ histopathHistopathology
- 01Diffuse sheets of medium-sized monotonous lymphoid cells
- 02Squared-off cytoplasm, multiple nucleoli
- 03Numerous tingible-body macrophages producing 'starry-sky' pattern
- 04Ki-67 ≈ 100%
§ radiographicRadiographic Features
- 01Moth-eaten radiolucency
- 02Loss of lamina dura
- 03Floating teeth
- 04Cortical destruction with soft-tissue mass
§ investigationsInvestigations
- 01Incisional biopsy with fresh tissue for FISH
- 02CT/MRI head-neck, chest-abdomen-pelvis
- 03Bone marrow biopsy
- 04LDH, uric acid (tumour lysis risk)
§ ihcIHC / Special Stains
- 01CD20+, CD10+, BCL6+
- 02BCL2 negative
- 03MYC rearrangement by FISH
§ treatmentTreatment
- 01Intensive short-course chemotherapy (CODOX-M/IVAC, DA-EPOCH-R)
- 02Rituximab
- 03Intrathecal methotrexate for CNS prophylaxis
- 04Aggressive tumour lysis prophylaxis (hydration, allopurinol, rasburicase)
§ complicationsComplications
- 01Tumour lysis syndrome
- 02Airway obstruction
- 03CNS relapse
§ prognosisPrognosis
Endemic: 80–90% cure with intensive chemo. Sporadic adult: 70–80%. HIV-associated: worse.
§ examKey Examination Points
- 01Child with rapidly growing jaw mass — biopsy immediately
- 02Send fresh tissue for cytogenetics
§ revisionQuick Revision Summary
- 01MYC t(8;14) · starry-sky · Ki-67 100% · CODOX-M/IVAC
§ vivaBDS Viva Questions
- 01What is starry-sky appearance?
- 02Endemic vs sporadic BL?
- 03What is tumour lysis syndrome?
§ mcqsMCQs — Assessment (3)
Question 1
Characteristic translocation:
Question 2
'Starry-sky' cells are:
Question 3
Ki-67 in BL:
§ evidenceReferences & Evidence
Current Classification
WHO Classification of Head and Neck Tumours
5th Edition — Volume 9
WHO Classification of Tumours Editorial Board · 2022
The authoritative international classification of head and neck, odontogenic and salivary gland tumours. Current terminology on this site follows this edition.
Evidence summary
Highest level of evidence linked to this page: WHO / Official Classification.
- L1 · Classification — 2
- L6 · Textbook — 3
1 linked source was published from 2024 onwards. Where guidance is limited or contested, rely on the higher-level sources above rather than this summary. Educational use only — not a substitute for clinical judgement.
Content last reviewed
September 2026
Evidence last reviewed
September 2026
Next scheduled review
September 2027
Review status
EVIDENCE REVIEWED
Search latest PubMed evidence
Last literature search: 7 September 2026
Current Classification
WHO Classification of Tumours Editorial Board. IARC / World Health Organization · 2022
The authoritative international classification of head and neck, odontogenic and salivary gland tumours. Current terminology on this site follows this edition.
IARC / WHO. IARC · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Histopathology References
Barnes L. CRC Press · 2008
Detailed histopathological reference for head and neck diagnostic criteria.
Textbook References
Neville BW, Damm DD, Allen CM et al.. Elsevier · 2024
Standard reference textbook of oral and maxillofacial pathology used throughout this atlas.
Rajendran R, Sivapathasundharam B. Elsevier · 2020
Undergraduate and postgraduate oral pathology textbook widely used in BDS and FCPS curricula.
Additional sources cited on this page
- WHO Classification of Haematolymphoid Tumours 2022
Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.