[Malignant lymphoma of the Burkitt type. Study of 21 cases in childhood]

From a group of 151 malignant lymphomas in childhood the authors selected 21 cases of malignant Burkitt lymphoma. The histopathological diagnosis was checked using common paraffin material, and a basic clinicopathological correlations was made. Malignant lymphoma of the Burkitt type was characterized by a diffuse type of growth with striking cellular cohesion. From the cytological aspect it was uniform with minimal differences in cell size. The presence of macrophages forming a "starry-sky" phenomenon was constant in the bioptic material. It is, however, not specific for Burkitt's lymphoma. In necroptic material macrophages were often absent and the morphology of tumour cells was altered. In the differential diagnosis it is necessary to differentiate in particular malignant lymphoblastic lymphomas and monomorphous centroblastomas. The malignant of Burkitt lymphoma type was localized in the majority of patients in the abdominal cavity, less frequently on the neck and in Waldeyer's ring. The mediastinum was not primarily affected. Five patients survive for 16-52 months after termination of oncological therapy without a relapse. Twelve patients died from generalization of the process, or from complications. Eight of those who died had a primary tumour in the abdominal cavity. The mean interval between the bioptic diagnosis and death was 3.6 months. As to the primary localization of the tumour and some other clinical and pathological data, various authors differ--these differences are discussed in relation to possible variations in the distribution of the tumour under different geographical conditions.