9A, 9B, and 9C). The spleen is not often involved in Burkitt lymphoma; however, the most common radiologic finding is diffuse splenomegaly. Ann. It is considered endemicin parts of Africa where rates are up to 50 times higher than in the USA. PET/CT also has better dosimetry, which is particularly important when imaging children, in comparison with gallium scintigraphy [15]. J. Hematol. Although Burkitt lymphoma can involve the head and neck in children, the gastrointestinal tract, genitourinary tract, gonads, mesentery, peritoneum, and retroperitoneum are also potential sites of involvement. Marked dilatation of the biliary system can occur when a mass infiltrates the pancreatic head [11] (Figs. AJR Am J Roentgenol. In adults, the prognosis is poorer, with a 5-year survival rate of ~50% and is even worse with bone marrow or CNS involvement (>30% 5-year survival rate) 4. Only 13% of all cases of lymphoma involve the gallbladder, and approximately 11% of non-Hodgkin's lymphoma cases involve the gallbladder [30, 31]. CONCLUSION. In our cases, we found a child who presented with perforated acute appendicitis who was diagnosed with Burkitt lymphoma postoperatively after appendectomy. Non-Hodgkin's lymphoma more commonly involves the kidney than does Hodgkin's lymphoma [27]. That is why it is strongly recommended patients seek an opinion from an expert in lymphoma. Children may also present with obstructive jaundice if extrahepatic bulky adenopathy compresses the biliary tree in the porta hepatis [1, 8, 11, 12]. (1995) Biographical memoirs of fellows of the Royal Society. HIV/AIDS 2. post-transplant imm… Ferry JA. Burkitt's lymphoma: clinicopathologic features and differential diagnosis. Sonography is the primary imaging technique and most often shows hypoechoic intratesticular lesions in secondary and primary Burkitt lymphoma [37, 38]. 5). 2009;192 (5): 1304-15. There is no small or large bowel obstruction. The most common finding of stomach involvement at CT is diffuse infiltration of the gastric wall (Figs. 1. Extranodal involvement is common (~30%) at presentation, most often presenting as an abdominal or pelvic mass. Burkitt leukemia: tumor cells present in blood and diffuse marrow involvement at diagnosis; leukemic cases were previously classified as FAB-L3 ; B cell lymphoma, unclassifiable, with features intermediate between Burkitt lymphoma and diffuse large B cell lymphoma: lymphomas with 2 translocations involving c-MYC and BCL2 or BCL6 (Am J Clin Pathol 2010;134:258) Involvement of the lymph nodes in the mesentery and retroperitoneum by Burkitt lymphoma commonly presents as abdominal and pelvic masses. 7A and 7B). Sonographic imaging findings of Burkitt lymphoma involving the epididymis include a hypoechoic mass or heterogeneously increased echogenicity [39]. Cross-sectional imaging is necessary to determine the distribution, severity, and staging to implement appropriate therapy. The pancreas is involved in Burkitt lymphoma in approximately 10% of cases [19]. Peritoneal nodularity. Since then, Burkitt lymphoma has been categorized by the World Health Organization into three types: endemic, sporadic, and immunodeficiency-associated types [6]. PET/CT recently has become the preferable functional imaging technique in children because of the shorter interval between injection and imaging, completion of the studies in only a few hours, improved image quality, and better dosimetry. Ultrasound is used initially if a child presents with an abdominal or pelvic mass. The clinical presentation of Burkitt lymphoma is varied and depends on the site of involvement. Clinical features are similar to acute cholecystitis [32]. We correlated these features with the imaging findings of non-Hodgkin's lymphoma. Accurate diagnosis of Burkitt lymphoma is critical because Burkitt lymphoma and DLBCL are treated differently. In that the tumor does not elicit a desmoplastic response, bowel obstruction is most often caused by intussusception [21, 22]. 13A and 13B); encasement of the major mesenteric vessels is common. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Primary breast lymphoma. Unable to process the form. 6. Some masses may have necrotic centers containing fluid (Figs. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. In the past, gallium scintigraphy was the best functional imaging technique for the evaluation of Burkitt lymphoma. Biko DM, Anupindi SA, Hernandez A et-al. Diffuse hypoechoic replacement in the testes with or without hyperemia [10], has also been reported (Fig. Types of calcifications include small punctuate foci within nodes, small calcifications around necrotic areas, and amorphous or linear calcifications in the periphery of large masses [10, 33, 34]. Imaging techniques most often used include ultrasound, CT, PET/CT, gallium scintigraphy, and bone scintigraphy. Pediatric patients typically present with Burkitt lymphoma with extranodal involvement, specifically occurring in the abdomen approximately 31% of the time [1]. Burkitt lymphoma involving the kidneys can result in renal failure secondary to obstruction or tumor infiltration of the kidneys or in paraneoplastic effects that manifest as glomerulonephritis, paraproteinemia, or cryoglobulinemia [13].