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Chapter 41

Burkitt's Lymphoma

In the late 1950s Dr. Denis Burkitt, a surgeon at Mulago Hospital (the teaching hospital of what was then the University of East Africa in Kampala, Uganda) described " a sarcoma involving the jaws of African children"; it proved to be a tumor of immense significance in the field of cancer research and therapy, offering insights into the whole field of oncology. Burkitt and his colleagues were the first to describe the tumor in detail in English, but Portuguese physicians in Mozambique were already very familiar with this tumor, and had carefully recorded it. The Babelewo, the tribal doctors of Nigeria, West Africa, on the other side of the continent, knew of this disease and perhaps how to treat it successfully. Probably the earliest recorded case was reported in 1928 by an American dentist in Oregon, who described a young patient who had a "sarcoma of the ovary with oral mastases". Perhaps by chance, in 1990 the school of dentistry in Oregon described a young American boy with jaw tumors and abdominal masses. Fifty years before Burkitt, Sir Albert Cook, who also practiced in Uganda, had recognized the local jaw tumors as being unusual but did not categorize them as lymphomas. Now the literature on this interesting malignancy is vast, controversial and to most non-pathologists, somewhat confusing.

Synonyms

Burkitt's lymphoma. Burkitt's tumor. The African lymphoma. Multicentric sarcoma.

Definition

Burkitt's lymphoma is the eponym given to a malignant tumor of the hematopoietic system, characterized by undifferentiated lymphocytes. It is a high-grade, small, non-cleaved, diffuse, non-Hodgkin's lymphoma: a B-cell neoplasm. There are at least two forms, and perhaps more. It was first defined accurately by Berard et al. in the Bulletin of the World Health Organization (1969). Despite many descriptions of its cytological and tissue culture appearances, there are still divergent views concerning the nature of the primitive blast cell and the varying relationship with the Epstein-Barr and other viruses.

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