Burkitt's Lymphoma - Epstein Barr virus

Burkitt's lymphoma is a tumour which was first described in 1958 by Denis Burkitt, a surgeon working in Africa. It is a tumour of Lymphocytes which form part of the white cell population in the blood and lymph glands. It is one form of non-Hodgkin's lymphoma.

In almost all cases of African Burkitt's lymphoma the cells carry a virus known as Epstein-Barr virus. The type of cell affected in Burkitt's lymphoma is the B lymphocyte which is normally involved in fighting infection by producing antibodies.

Burkitt's lymphoma is generally divided into two forms: African Burkitt's lymphoma and non-African Burkitt’s lymphoma. It is the most common childhood tumour in equatorial Africa but is very rare in children in Western countries. Recently Burkitt's lymphoma has been diagnosed in around 2% of AIDS patients.

In almost all cases of African Burkitt's lymphoma the cells carry a virus known as Epstein-Barr virus (EBV) named after the two British scientists who discovered it.

This virus is very common and over 90% of adults throughout the world have evidence of past infection. Clearly not everyone develops the tumour and so EBV alone does not cause Burkitt's lymphoma. It must be only one of the factors necessary for the disease to develop.

Other possible contributory factors are chronic malaria infection in Africa and infection with the AIDS virus (human immunodeficiency virus - HIV) in Western countries.

Signs and Symptoms of Burkitt's Lymphoma

The effects of Burkitt's lymphoma on the patient depend on the site of the tumour in the body. In African Burkitt's lymphoma the jaw is the commonest site where it causes visible swelling of the cheek and loosening of the teeth. In non-African Burkitt’s lymphoma the tumour commonly arises in the abdomen where it causes swelling and discomfort.

Like all malignant tumours, Burkitt's lymphoma is very rapidly growing and often arises in, or spreads to, multiple sites.

Burkitt's lymphoma is diagnosed from a biopsy sample of the tumour. A small piece of the tumour is removed by surgery and the sample, stained by specific dyes, is examined under the microscope by a pathologist.

Burkitt's lymphoma can be differentiated from other tumours by the distinctive pattern of tumour cells which is known as a starry-sky pattern. It is possible to use specialised laboratory techniques to determine the presence of EBV in the tumour cells.

Although Burkitt's lymphoma is a very rapidly growing tumour it responds well to treatment. In African children the drug cyclophosphamide is the treatment of choice. This drug is so effective that one dose may be enough to cause the tumour to disappear. However, it is very important to complete the course of treatment in order to prevent the tumour recurring.

In AIDS patients treatment is less successful because of the underlying HIV infection. In addition to drugs, these patients are usually given X-rays which cause the tumour to shrink.

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