7 Key Signs of Burkitt Lymphoma You Should Know

Burkitt lymphoma is a rare and highly aggressive type of non-Hodgkin lymphoma that affects the B-cells of the immune system. This fast-growing cancer can develop in various parts of the body, including the lymph nodes, bone marrow, spinal fluid, and organs such as the jaw, abdomen, and central nervous system. Named after Denis Burkitt, who first described the condition in African children in 1958, this lymphoma requires prompt recognition and medical attention due to its rapid progression.

Understanding the warning signs of Burkitt lymphoma is crucial for early detection and timely medical intervention. While this condition is rare, affecting approximately 2-3 people per million annually in developed countries, recognizing its symptoms can make a significant difference in outcomes. The disease primarily affects children and young adults, though it can occur at any age. Let’s explore the most common signs and symptoms that may indicate the presence of Burkitt lymphoma.

1. Rapidly Growing Lumps or Swelling

One of the most noticeable signs of Burkitt lymphoma is the sudden appearance of rapidly enlarging lumps or masses. These swellings typically occur in the lymph nodes but can develop in various body locations depending on the type of Burkitt lymphoma.

In endemic Burkitt lymphoma, commonly found in equatorial Africa, the jaw and facial bones are frequently affected. Patients may notice a painless but rapidly expanding mass in the jaw area that can cause facial deformity within days or weeks. The swelling may become visible on one or both sides of the face and can affect the alignment of teeth.

In sporadic Burkitt lymphoma, more common in Western countries, abdominal masses are typical. These masses can grow so quickly that the abdomen becomes noticeably distended within a short period. The lymph nodes in the neck, armpits, or groin may also swell dramatically, often doubling in size within 24-48 hours.

Key characteristics:

• Extremely rapid growth (visible changes within days)
• Usually painless in early stages
• Can occur in jaw, abdomen, lymph nodes, or other areas
• May feel firm or rubbery to touch

2. Abdominal Pain and Discomfort

Abdominal involvement is particularly common in sporadic Burkitt lymphoma, making abdominal pain one of the most frequent presenting symptoms. This pain results from tumor growth in the abdominal organs, lymph nodes, or intestinal walls.

The pain can vary in intensity and character. Some patients experience a constant, dull ache in the belly, while others have sharp, cramping pains. The discomfort may be localized to one area or spread throughout the abdomen. As the tumor grows, it can press on surrounding organs and structures, intensifying the pain.

In some cases, the tumor can cause bowel obstruction, leading to severe cramping pain, inability to pass gas or stool, and abdominal distension. The tumor may also affect the appendix or intestinal area, sometimes mimicking acute appendicitis, which can lead to misdiagnosis initially.

Additional abdominal symptoms may include:

• Feeling of fullness or bloating
• Reduced appetite due to mass effect
• Changes in bowel habits
• Visible abdominal swelling or distension

3. Nausea and Vomiting

Gastrointestinal symptoms, particularly nausea and vomiting, frequently accompany Burkitt lymphoma, especially when the tumor involves the abdomen. These symptoms can significantly impact a patient’s quality of life and nutritional status.

The nausea may be persistent and worsen with eating, leading to decreased food intake and subsequent weight loss. Vomiting can occur sporadically or become more frequent as the disease progresses. When the tumor obstructs the intestinal tract, vomiting may become more severe and contain bile or even partially digested food.

These symptoms occur for several reasons. The growing tumor mass can directly compress the stomach or intestines, causing mechanical obstruction. Additionally, the cancer can infiltrate the intestinal wall, disrupting normal digestive processes. The body’s response to the cancer itself can also trigger nausea through the release of various chemical mediators.

Patients may also experience:

• Loss of appetite (anorexia)
• Early satiety (feeling full after eating small amounts)
• Acid reflux or heartburn
• Altered taste perception

4. Unexplained Fatigue and Weakness

Profound fatigue is a common systemic symptom of Burkitt lymphoma that affects patients’ daily functioning. This exhaustion goes beyond normal tiredness and doesn’t improve with rest or sleep. The fatigue associated with this lymphoma can be debilitating, making even simple tasks feel overwhelming.

Several mechanisms contribute to this fatigue. The rapidly dividing cancer cells consume significant amounts of the body’s energy and nutrients. The cancer can infiltrate the bone marrow, interfering with normal blood cell production and leading to anemia (low red blood cell count), which reduces oxygen delivery to tissues and causes weakness and exhaustion.

The body’s immune response to the cancer also plays a role. The constant activation of the immune system and the release of inflammatory chemicals called cytokines can cause a syndrome known as “cancer-related fatigue,” which is distinct from normal tiredness.

Associated symptoms include:

• Muscle weakness and heaviness in limbs
• Difficulty concentrating or “brain fog”
• Reduced stamina and exercise tolerance
• Need for frequent rest periods during the day
• Lack of energy despite adequate sleep

5. Fever and Night Sweats

Constitutional symptoms, also known as “B symptoms” in lymphoma classification, are significant indicators of Burkitt lymphoma. These include fever and drenching night sweats that are characteristic of many lymphomas.

The fever associated with Burkitt lymphoma may come and go without an apparent infection source. It’s often low-grade but can spike higher, particularly in the evening. Unlike fevers from common infections, this fever doesn’t respond well to standard over-the-counter fever reducers and tends to recur persistently.

Night sweats in Burkitt lymphoma are typically severe and drenching—so profuse that patients may need to change their sleepwear and bed sheets during the night. These sweats are different from occasional nighttime perspiration and occur regularly. They’re caused by the body’s response to the cancer, including the release of chemicals called pyrogens that affect the body’s temperature regulation.

Characteristics of these symptoms:

• Fever without obvious infection source
• Temperature fluctuations, often worse in evening
• Night sweats requiring clothing or bedding changes
• Chills or shivering episodes
• Symptoms persisting despite antibiotics (if given for suspected infection)

6. Unexplained Weight Loss

Significant, unintentional weight loss is another hallmark symptom of Burkitt lymphoma and is considered one of the “B symptoms” that indicate more advanced or aggressive disease. This weight loss is defined as losing more than 10% of body weight over a six-month period without trying to lose weight through diet or exercise changes.

The weight loss in Burkitt lymphoma occurs through multiple mechanisms. The rapidly growing cancer cells have high metabolic demands, essentially “stealing” nutrients from the body to fuel their uncontrolled growth. This creates a state similar to starvation, even when adequate calories are consumed.

Additionally, the cancer causes metabolic changes that alter how the body processes nutrients. Proteins are broken down faster than they’re built up, leading to muscle wasting. The nausea, vomiting, and abdominal discomfort associated with the disease further reduce food intake, compounding the weight loss.

Patients or caregivers might notice:

• Clothes becoming noticeably looser
• Visible loss of muscle mass
• Facial features appearing more gaunt
• Weight loss continuing despite attempts to eat more
• Accompanying loss of appetite

7. Neurological Symptoms

When Burkitt lymphoma spreads to the central nervous system (CNS), it can cause a variety of neurological symptoms. CNS involvement occurs in approximately 10-20% of Burkitt lymphoma cases and represents a serious complication requiring immediate medical attention.

The symptoms depend on which parts of the nervous system are affected. When the cancer infiltrates the brain or the membranes surrounding the brain (meninges), patients may experience severe headaches that progressively worsen and don’t respond to typical pain relievers. These headaches may be accompanied by nausea and vomiting, particularly in the morning.

Seizures can occur when the tumor irritates the brain tissue, ranging from focal seizures affecting one body part to generalized convulsions. Changes in mental status, including confusion, difficulty concentrating, memory problems, or altered consciousness, may develop as the disease affects brain function.

Spinal cord involvement can cause back pain, weakness or numbness in the limbs, difficulty walking, and problems with bladder or bowel control. Cranial nerve involvement may lead to vision changes, facial weakness, hearing problems, or difficulty swallowing.

Warning neurological signs include:

• Persistent, worsening headaches
• Seizures or convulsions
• Vision changes or double vision
• Confusion or altered mental state
• Weakness, numbness, or tingling in limbs
• Difficulty with coordination or balance
• Facial drooping or weakness
• Problems with speech

Main Causes of Burkitt Lymphoma

While the exact cause of Burkitt lymphoma remains not fully understood, research has identified several risk factors and contributing elements associated with its development. Understanding these factors can help explain why some individuals are more susceptible to this aggressive cancer.

Epstein-Barr Virus (EBV) Infection

EBV, the virus that causes infectious mononucleosis (mono), is strongly associated with Burkitt lymphoma, particularly the endemic form found in Africa. Nearly all cases of endemic Burkitt lymphoma show evidence of EBV infection within the tumor cells. In sporadic cases found in developed countries, approximately 15-20% are EBV-positive. The virus appears to contribute to the transformation of normal B-cells into cancerous ones, though EBV infection alone is not sufficient to cause the disease, as millions of people carry the virus without developing lymphoma.

Chromosomal Abnormalities

A hallmark of Burkitt lymphoma is a specific chromosomal translocation involving the MYC gene on chromosome 8. In most cases, this gene abnormally swaps places with chromosome 14, though translocations involving chromosomes 2 or 22 can also occur. This genetic rearrangement causes the MYC gene to be overexpressed, leading to uncontrolled cell growth and division. This chromosomal change is found in nearly all Burkitt lymphoma cases and is considered a defining feature of the disease.

Immunodeficiency States

People with compromised immune systems have a significantly increased risk of developing Burkitt lymphoma. This includes individuals with HIV/AIDS, where Burkitt lymphoma is considered an AIDS-defining illness. The immunodeficiency-associated form accounts for a significant proportion of cases in areas with high HIV prevalence. Additionally, people who have undergone organ transplantation and receive immunosuppressive medications to prevent rejection are at elevated risk. Inherited immunodeficiency disorders also increase susceptibility to this cancer.

Malaria Endemic Areas

In equatorial Africa, where endemic Burkitt lymphoma is most common, chronic malaria infection appears to play a contributing role. Repeated malaria infections cause chronic immune stimulation, particularly of B-cells, which may create conditions favorable for lymphoma development when combined with EBV infection. This explains why endemic Burkitt lymphoma is geographically concentrated in regions where both malaria and EBV are prevalent.

Age and Gender Factors

Burkitt lymphoma shows specific demographic patterns. Endemic Burkitt lymphoma typically affects children between ages 4 and 7, with boys affected twice as often as girls. Sporadic Burkitt lymphoma has a median age of onset around 30 years but can occur throughout childhood and adulthood. Immunodeficiency-associated cases typically occur in young to middle-aged adults with HIV/AIDS. Males are generally affected more frequently than females across all types.

Frequently Asked Questions

What is the difference between Burkitt lymphoma and other lymphomas?

Burkitt lymphoma is distinguished by its extremely rapid growth rate—it’s one of the fastest-growing human cancers, with the tumor potentially doubling in size within 24-48 hours. It also has characteristic chromosomal changes involving the MYC gene and specific microscopic appearances that differentiate it from other non-Hodgkin lymphomas. While many lymphomas grow slowly over months or years, Burkitt lymphoma progresses in days to weeks, making urgent diagnosis and treatment essential.

How quickly do symptoms of Burkitt lymphoma develop?

Symptoms of Burkitt lymphoma typically develop very rapidly, often over the course of just a few days to a few weeks. Patients or parents may notice swelling or lumps that seem to appear overnight or grow visibly larger each day. This rapid onset is a hallmark of the disease and distinguishes it from many other conditions. If you notice rapidly enlarging lumps, worsening abdominal swelling, or quickly progressing symptoms, seek medical attention immediately.

Who is most at risk for developing Burkitt lymphoma?

Risk varies by the type of Burkitt lymphoma. Endemic Burkitt lymphoma primarily affects children in equatorial Africa, particularly in malaria-endemic regions. Sporadic Burkitt lymphoma can affect people of any age but is most common in children and young adults in Western countries. Immunodeficiency-associated Burkitt lymphoma primarily affects people with HIV/AIDS or those taking immunosuppressive medications after organ transplantation. Males are affected approximately twice as often as females across all types.

Can Burkitt lymphoma be detected through routine blood tests?

Routine blood tests may show abnormalities that suggest something is wrong—such as anemia, elevated white blood cell counts, or abnormal liver or kidney function—but they cannot definitively diagnose Burkitt lymphoma. The diagnosis requires a tissue biopsy of the affected area, which is then examined under a microscope and tested for specific genetic markers. Blood tests may also show elevated levels of lactate dehydrogenase (LDH) and uric acid, which are common in rapidly growing tumors, but these findings are not specific to Burkitt lymphoma.

Is Burkitt lymphoma hereditary or contagious?

Burkitt lymphoma is not directly hereditary—it doesn’t pass from parents to children through genes. However, certain inherited immune deficiency disorders can increase the risk. The disease is also not contagious and cannot be transmitted from person to person. While Epstein-Barr virus (associated with some cases) is contagious, the vast majority of people infected with EBV never develop lymphoma. The development of Burkitt lymphoma requires multiple factors coming together, including genetic mutations that occur during a person’s lifetime.

What should I do if I suspect Burkitt lymphoma symptoms?

If you or a loved one experiences rapidly growing lumps, persistent abdominal swelling, unexplained weight loss, persistent fever and night sweats, or any concerning neurological symptoms, seek medical attention immediately. Due to the aggressive nature of Burkitt lymphoma, time is critical. Contact your primary care physician or go to an emergency department for evaluation. Be sure to mention the rapid onset of symptoms, as this information helps medical professionals prioritize appropriate testing. Early evaluation can include physical examination, blood tests, imaging studies, and possibly a biopsy to establish a diagnosis.

Can children develop Burkitt lymphoma?

Yes, Burkitt lymphoma frequently affects children and is actually one of the most common types of non-Hodgkin lymphoma in pediatric populations. Endemic Burkitt lymphoma primarily occurs in children aged 4-7 years in equatorial Africa, while sporadic Burkitt lymphoma can affect children and adolescents worldwide. Parents should be particularly alert to rapidly developing lumps in the jaw or neck, abdominal swelling, or behavioral changes in children. While Burkitt lymphoma is serious, children often respond well to appropriate medical intervention when the disease is caught early.

References:

• American Cancer Society – Burkitt Lymphoma
• National Cancer Institute – Non-Hodgkin Lymphoma Treatment
• Mayo Clinic – Non-Hodgkin’s Lymphoma
• NHS – Non-Hodgkin Lymphoma
• Lymphoma Research Foundation – Burkitt Lymphoma