# Burkitt lymphoma

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Burkitt Lymphoma - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK538148/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class BD25.04 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
BURKITT LYMPHOMA
Sources: Burkitt Lymphoma - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK538148/ · ICPC-3
         (WONCA International Classification of Primary Care, 3rd edition) class BD25.04 - condition
         scope only, no dose · No dose - referral pathway, no medicine given in primary care
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (5)
    - A rapidly growing mass with high LDH and uric acid reflects the tumor's fast doubling time
    - Endemic disease classically causes an enlarging jaw lesion, swelling around the eye, or
      genitourinary involvement
    - Sporadic disease usually starts in the abdomen, with abdominal pain, distention, nausea,
      vomiting, and GI bleeding  [abdominal pain · bleeding · nausea · vomiting]
    - Adults are more likely than children to have fever, weight loss, and night sweats  [fever ·
      night sweats · weight loss]
    - Immunodeficiency-related disease presents with symptoms tied to the underlying immune
      disorder, such as AIDS or post-transplant immunosuppression
  SIGNS - what you find (4)
    - Jaw involvement occurs mainly in children with the endemic form
    - Bone marrow involvement is found in fewer than 10% of patients at diagnosis but is common as
      the disease relapses or resists treatment  [relapse]
    - The immunodeficiency-related form often involves lymph nodes, bone marrow, and the central
      nervous system
    - Bone marrow involvement over 25% of cellularity is classified as Burkitt leukemia rather than
      lymphoma
  TESTS (5)
    - Excisional biopsy is preferred over fine-needle aspiration since FNA often yields insufficient
      tissue
    - In developed countries diagnosis is suspected on microscopy or flow cytometry and confirmed
      with immunohistochemistry and cytogenetics
    - After tissue diagnosis, bone marrow and spinal fluid are evaluated to stage the extent of
      disease
    - CT of chest, abdomen, and pelvis plus whole-body PET/CT are done for staging, without delaying
      treatment
    - Required labs include CBC with differential, ESR, a metabolic panel, coagulation studies, LDH,
      uric acid, hepatitis B serology, and HIV and pregnancy testing
  IF NOT THIS - what else fits (5)
    - Other CD10-positive B-cell malignancies can mimic it, among them DLBCL, high-grade B-cell or
      follicular lymphoma, and B-ALL
    - A low Ki-67 index under 90% together with BCL2 positivity points away from a Burkitt diagnosis
    - An MYC translocation does not confirm Burkitt lymphoma, since roughly 10% of DLBCL also carry
      it
    - B-ALL can resemble Burkitt lymphoma in size but typically has finer chromatin and expresses
      immaturity markers like CD34 and TdT
    - Burkitt-like lymphoma with 11q aberration lacks an MYC translocation but has a similar
      prognosis
  Source  StatPearls "Burkitt Lymphoma" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    A highly aggressive, fast-growing lymphoma (associated with EBV and HIV) that is an
            oncologic emergency requiring same-day referral to haematology/oncology; nothing is
            prescribed at primary-care level. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      A highly aggressive, fast-growing lymphoma (associated with EBV and HIV) that is an
            oncologic emergency requiring same-day referral to haematology/oncology; nothing is
            prescribed at primary-care level.
   Caution  RED FLAG - Airway compromise from massive head and neck lymphadenopathy: assess urgently
            and refer.
            No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - A rapidly growing jaw, abdominal or neck mass: refer urgently. Very rapid
            growth is itself urgent because of the tumour lysis risk, as are known HIV infection and
            abdominal pain or distension in a child.

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