Burkitt lymphoma is a very fast growing form of non-Hodgkin's lymphoma.

B-cell lymphoma; High-grade B-cell lymphoma; Small noncleaved cell lymphoma

This type of tumor was first discovered in children in certain parts of Africa, but it also occurs in the United States.

The African type of Burkitt lymphoma is closely associated with the Epstein-Barr virus (EBV), the main cause of infectious mononucleosis. The North American form of Burkitt lymphoma is not linked to EBV.

The majority of Burkitt lymphoma cases are seen in males.

Burkitt lymphoma may first be noticed as a swelling of the lymph nodes (glands) in the neck, groin, below the jaw, or under the arm. These swollen lymph nodes are often painless, but can grow very rapidly.

In the more common types seen in the United States, the cancer usually starts in the belly area (abdomen). The disease can also start in the ovaries, testes, brain, and spinal fluid.

Symptoms include:

• Nodes that grow together to form a lump
• Nontender nodes
• Rapid growth of the lymph nodes
• Unexplained swollen lymph nodes

• Bone marrow biopsy
• Chest x-ray
• CT scan of the chest, abdomen, and pelvis
• Examination of the spinal fluid
• Lymph node biopsy
• PET or gallium scan

Chemotherapy is used to treat this type of cancer. Commonly used medicines include prednisone, cyclophosphamide, vincristine, cytarabine, doxorubicin, methotrexate, and others.

More than half of those with Burkitt lymphoma can be cured with intensive chemotherapy. The cure rate may be lower if the cancer spreads to the bone marrow or spinal fluid.

• Complications of treatment (radiation therapy or chemotherapy)
• Spread of the cancer

Call your health care provider if you have symptoms of Burkitt lymphoma.

Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: p.1411.

Primary lymphoma of the brain is cancer of the lymph cells that starts in the brain.

Brain lymphoma; Cerebral lymphoma; Primary lymphoma of the central nervous system; Lymphoma - brain

The cause of primary brain lymphoma is unknown. It is more common in people ages 45 - 70.

Patients who have a weakened immune system are at greater risk for primary lymphoma of the brain. Common causes of a weakened immune system include:

• HIV
• Organ transplants (especially heart transplants)

Primary lymphoma of the brain is also linked to Epstein-Barr Virus (EBV) infection, the virus that causes mononucleosis.

The rate of primary brain lymphoma is rising, but it is still relatively rare.

• Changes in speech
• Changes in vision
• Confusion
• Fever
• Hallucinations
• Headaches
• Numbness to hot, cold, and pain
• Personality changes
• Seizures
• Weakness in hands
• Weight loss

The following tests may be performed to help diagnose a primary lymphoma of the brain:

• Biopsy of the brain
• CSF cell count
• CSF total protein
• Head CT scan or MRI

The condition is usually first treated with corticosteroids to control any local swelling and improve symptoms. However, chemotherapy may increase survival by 3 - 4 years, or longer. The chemotherapy is usually high doses of methotrexate given through a vein (intravenously) or a spinal tap(intrathecally).

Treating patients with weakened immune systems is not as successful, but it is improving.

Radiation therapy used to be the main treatment for primary lymphoma of the brain. Now it is usually reserved for treating patients who do not respond to chemotherapy.

Treatment with multiple therapies (combination therapy) is common.

The survival of untreated primary brain lymphoma is under 2 months. Treated with chemotherapy, patients often survive 3 - 4 years or more. About 40% of patients are alive at 5 years. In general, older patients have a worse outlook than younger patients.

Possible complications include:

• Chemotherapy side effects, including low blood counts
• Radiation side effects, including confusion, headaches, nervous system (neurologic) problems, and tissue death
• Return (recurrence) of the lymphoma

DeAngelis LM. Tumors of the central nervous system and intracranial hypertension and hypotension. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 199.

National Cancer Institute. Primary CNS lymphoma treatment (PDQ). 2009. Accessed February 25, 2009.