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[Burkitt lymphoma]

1. Introduction to GI Burkitt lymphoma (Sharma. Am J Hematol 2001;67:48-50)

1) Burkitt’s lymphoma is a B-cell high-grade lymphoma that is endemic in Africa, but sporadic (non-endemic) cases are reported the world over.

2) Only 1-2% of all adult NHL are of Burkitt’s variety; however, in the setting of HIV infection, Burkitt's lymphoma may account for about 35-40% of all NHL patients.

3) In the pediatric non-HIV population 25-30% of all NHL will be of Burkitt’s variety.

4) For non-endemic Burkitt’s, the GI tract is the most common site, followed by retroperitoneum, kidney, ovary, and testes.

5) Burkitt’s lymphoma of stomach is extremely rare in adults.

2. Histology and differential diagnosis of Burkitt lymphoma (Krugmann. Leuk Lym 2004;45:1055)

1) Histologically, cohesive sheets of medium-sized blasts with up to five small nucleoli and a basophilic cytoplasm characterize BL.

2) Numerous apoptotic cells with ‘‘starry sky’’ macrophages and an increased proliferation rate with 95% Ki-67 positive cells are the hallmarks of BL.

3) The neoplastic blast population is of B-cell phenotype with expression of CD19, CD20, and CD22. The lymphoid blasts show positivity for CD10 and BCL-6, however, CD5, CD23, TdT and BCL-2 are negative.

4) At the molecular level, BL are characterized by the Burkitt-translocation t(8;14) (q24;32) or one of its variants, which result in a juxtaposition of the MYC oncogene next to one of the immunoglobulin (IG) gene loci.

3. Representative case of gastric Burkitt lymphoma

4. Gastric Burkitt lymphoma has a relatively good prognosis

5. Endoscopic findings of gastric Burkitt lymphoma at SMC (Jung & Lee. Korean J Gastrointest Endosc 2008:37-13)

Abdominal pain이 가장흔한 증상이었고 epigastri soreness가 뒤를 이었습니다. 42%에서 B symptom이 있었습니다.

6. More cases of gastric Burkitt lymphoma

Case 1:

Case 2:

7. Case: Intussusception by appendiceal Burkitt lymphoma

8. Case: Burkitt lymphoma of the terminal ileum

우하복부 통증과 체중감소로 내원한 60대 남성입니다.

Burkitt lymphoma
. CD10: Positive
. Ki-67: Positive (>99%)
. Bcl-2: Negative
. MUM-1: Negative
. CD20: Positive

© 일원내시경교실 바른내시경연구소 이준행. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.