Burkitt's lymphoma in the appendicular skeleton.

Area of Science:

• Pediatric Oncology
• Skeletal Radiology
• Hematology-Oncology

Background:

• Burkitt's lymphoma is an aggressive non-Hodgkin lymphoma.
• Skeletal involvement is rare but can present with significant bone destruction.

Purpose of the Study:

• To describe the radiological and clinical features of Burkitt's lymphoma in bone and soft tissues in Ugandan children.
• To highlight differential diagnostic considerations and treatment outcomes.

Main Methods:

• Retrospective review of 290 Ugandan children and adolescents with proven Burkitt's lymphoma.
• Analysis of radiological findings (X-rays, CT) and clinical presentations of 11 patients with bone/soft tissue lesions.

Main Results:

• 11 patients (3.8%) presented with bone and soft tissue lesions, primarily in long bones and pelvis.
• Lesions originated in the medulla, causing osteolysis, subperiosteal new bone formation, and soft tissue masses.
• Radiological mimics included Ewing's sarcoma, osteosarcoma, and osteomyelitis; lesions were relatively painless clinically.
• Five patients experienced pathological fractures; chemotherapy led to good healing without growth plate damage.

Conclusions:

• Skeletal Burkitt's lymphoma, though uncommon, exhibits characteristic radiological features.
• Painless presentation is a key clinical differentiator from other bone tumors and infections.
• Effective chemotherapy can lead to favorable healing of bone lesions and fractures.