Malignant lymphoma, undifferentiated, Burkitt's type in north-east Italy

Burkitt's lymphoma occurred in 15 Italian patients seen at Pordenone General Hospital over a period of seven years representing 8% of all malignant lymphomas seen in the same period. All patients were born and lived in a region of 100 miles radius around the north-eastern Italian town of Pordenone. Five patients lived in the same rural village, and another two were distant relatives. There were eleven males and four females; the median age was 29 years (range 9-68) with ten patients older than 15 years. Primary tumor was in the gastrointestinal tract regions in nine patients and in lymph nodes in six patients. Epstein-Barr virus serology was positive in one of the 12 patients tested. According to the Ziegler staging system, three patients were stage A, three stage AR, five stage C and four stage D. Treatment consisted in surgical removal of bulky tumor followed by combination chemotherapy in seven patients, combination chemotherapy alone in seven patients and palliative radiotherapy in one. Median survival was significantly higher in patients who have obtained an objective response than in those who have not (11.5 versus 4 months). Median survival was not significantly influenced by age, stage and treatment. This report would emphasize that in Europe there are areas of relatively high incidence of Burkitt's lymphoma, and the province of Pordenone is one of these: it must be considered in the histological diagnosis of lymphoma in these areas.