This article will discuss how Burkitt lymphoma is diagnosed, including physical examination, lab tests, imaging, and differential diagnosis.
Physical Examination
Tumors seen in Burkitt lymphoma can double in size in as little as 25 hours. With a visible tumor, the rapid growth will usually prompt a person to visit their doctor. A rapidly growing tumor that’s not visible outside the body may also start to cause symptoms that prompt a doctor’s visit.
Endemic: This type mainly occurs in children who live in equatorial Africa or Papua New Guinea. They typically present with masses or deformities of the jaw or face. Sporadic: This type usually occurs in children and young adults. It primarily affects the abdomen and bone marrow. Immunodeficiency-associated: This type of Burkitt lymphoma occurs in people who are immunocompromised, such as people with human immunodeficiency virus (HIV).
The healthcare professional will ask about your medical history and symptoms. They may ask:
Have you felt tired lately? Do you have any abnormal lymph node swelling? Do you have any abdominal pain or other gastrointestinal symptoms? Do you have HIV, or are you otherwise immunocompromised? Have you had any other unusual symptoms such as fever, night sweats, unexplained weight loss?
The healthcare professional will conduct a physical examination. The endemic form of Burkitt lymphoma often produces masses or growths of the mouth and jaw, which is something a doctor will notice upon examining you or your child.
Labs and Tests
Your healthcare professional will likely order blood tests to check for:
Anemia and abnormalities of white blood cells or platelets through a complete blood count (CBC)High blood uric acid level Increased lactate dehydrogenase levelHIV infection Hepatitis B
If a doctor suspects you have Burkitt lymphoma, the doctor will likely perform a biopsy, usually of a lymph node. A biopsy involves taking a small sample of tissue to be analyzed in a lab to determine whether it’s cancerous.
A biopsy can be done via needle aspiration or by cutting out a piece of tissue. Because aspiration doesn’t produce much tissue, some doctors may prefer to remove a portion of tissue to make a definitive diagnosis.
In underdeveloped countries, doctors may not have advanced imaging and testing tools at their disposal. If that’s the case, they may only rely on a physical exam and fine-needle aspiration biopsy.
Doctors may also perform a spinal tap to see if the cancer has spread to the central nervous system (CNS), which includes the brain and spinal cord. In this procedure, a needle is inserted into the lower back to draw a sample of cerebrospinal fluid from around your spinal cord.
Imaging
If a doctor believes your lab results are worrying, they may order imaging. These tests allow your doctor to look inside your body. Your doctor may order the following imaging tests if they suspect you have Burkitt lymphoma:
Computed Tomography (CT) Scan
A CT scan, using X-ray technology, provides your doctor with images of your internal tissues and organs. The procedure might require you to be injected with a contrast dye or ingest one. Your doctor may request imaging of your chest, pelvis, or abdomen.
Positron-Emission Tomography (PET) Scan
During this imaging test, a medical professional will inject you with radioactive sugar. Cancerous cells absorb higher levels of this substance, making them easy to spot on a PET scan.
Chest X-ray
A chest X-ray allows your doctor to see any masses in your chest.
Differential Diagnosis
Some conditions can cause symptoms similar to Burkitt lymphoma, namely, other types of lymphoma such as diffuse large B-cell lymphoma or Hodgkin’s lymphoma.
Where it’s located Whether it has spread to several areas The size of the tumor
A bone marrow biopsy will be performed to evaluate bone marrow involvement. It is a standard part of staging for lymphomas.Different staging criteria are used for children and adults. The stage of the cancer (from 1 to 4) helps to determine what treatment is best. Bulky disease is used to describe large chest tumors that may be present at any stage.
Some Burkitt lymphoma tumors may also resemble other types of tumors, such as Wilms tumor (a childhood tumor of the kidney) or salivary gland tumors.
Other differential diagnoses for Burkitt lymphoma include:
Kidney cancer Kidney disease Bacterial infection Viral infection HIV Sarcoidosis (a rare inflammatory disease often affecting the lymph nodes or lungs) Malnutrition Leukemia (a group of blood cancers)
Summary
The endemic form of Burkitt lymphoma is often diagnosed because someone presents with a mass or growth on their face or jaw. People with sporadic Burkitt lymphoma may go to the doctor because they have abdominal pain.
To make a diagnosis, a doctor performs a physical exam, takes a medical history, and orders tests such as urine and blood tests, a biopsy, or a spinal tap. Imaging studies then allow doctors to take a closer look inside the body and identify tumors or check for disease spread.
A Word From Verywell
Abnormal test results may worry you but aren’t a definitive sign that you have cancer. Many medical conditions can cause blood and urine tests to come back out of the normal range. And a doctor can’t make a diagnosis based on initial testing alone.
Additionally, symptoms such as abdominal pain, may occur because of other conditions. Let your doctor know about your symptoms and discuss potential next steps to find out the cause.
