Pediatric Burkitt Lymphoma

  • Etiology: highly aggressive B-cell lymphoma
  • Imaging: see bulky mass often with central necrosis in region of right lower quadrant / terminal ileum, mass has mesenteric vessel encasement and bowel wall thickening and masses causing intussusception, sandwich sign – bowel loops sandwiched between mesenteric masses, also see lesions in breast, liver, spleen, kidney, ovary, lymph nodes
  • Clinical: peak age 5 years, most common form of non-Hodgkin lymphoma in children < 15 yo, most common malignancy to involve mesentery and omentum

Radiology Cases of Burkitt Lymphoma

CT of Burkitt lymphoma of kidney
Coronal T1 MRI without contrast of the abdomen (upper left) shows bilateral enlarged kidneys which after the administration of contrast (upper right) is seen to be due to multiple non-enhancing renal masses. Transverse US of the liver (below) shows a round hypoechoic mass in the liver, superior and to the left of the gall bladder.
CT of Meckel's diverticulum causing small bowel obstructin
Axial (above), coronal (lower left) and sagittal (lower right) CT with contrast of the abdomen shows multiple dilated loops of small bowel and a soft tissue mass in the right upper quadrant just beneath the gall bladder that shows the target sign on the sagittal image and the pseudokidney sign on the transverse and coronal images. The soft tissue mass was still present on an US performed 1 hour later.

Surgery Cases of Burkitt Lymphoma

Surgical image of small bowel - small bowel intussusception due to Non-Hodgkin lymphoma
Laparoscopic surgical image (above) shows the small bowel-small bowel intussusception. Surgical image of the small bowel after reduction of the intussusception (below) shows the serosa is pink-tan and intact with a 1.5 x 0.6 cm puckered, red, firm area that when opened in pathology revealed a 2.6 x 2.0 cm red-pink mass.
Surgical image of Non-Hodgkin lymphoma in the mesentery
Surgical image obtained after intussusception reduction and resection of the intussusception’s pathological lead point shows multiple large mesenteric lymph nodes.

Gross Pathology Cases of Burkitt Lymphoma

Gross pathological image of small bowel - small bowel intussusception due to Burkitt lymphoma
Gross pathological images of the resected segment of intussuscepted small bowel shows on its serosal surface (above) a 2.0 x 1.2 cm irregular, tan-white centrally ulcerated and umbilicated firm area. The opened image of small bowel (below) reveals a 3.4 x 2.9 x 1.2 cm irregular, tan-white, smooth, firm mass which was sectioned to reveal smooth, tan-white, glistening, homogenous cut surfaces.