Burkitt lymphoma

Highly aggressive B‑cell NHL driven by MYC translocation; classic 'starry‑sky' histology.

• Explains explosive tumor growth in kids/young adults and emergent tumor lysis risk.

• Endemic (Africa): jaw/face mass; EBV‑associated
• Sporadic: abdominal/ileocecal mass, bowel obstruction
• Very high LDH; rapid doubling time

1. Think Burkitt with jaw mass + EBV or ileocecal mass with sky‑high LDH
2. Start tumor lysis prophylaxis immediately (IV fluids, allopurinol/rasburicase)

1. Intensive multi‑agent chemo (e.g., CODOX‑M/IVAC); CNS prophylaxis
2. Manage tumor lysis (aggressive hydration, rasburicase if uric acid high)

• Mnemonic: 8 → MYC: t(8;14) or variants t(2;8), t(8;22) place *MYC* next to heavy/light chain promoters

• Hyperkalemia, hyperphosphatemia, rising creatinine = tumor lysis emergency

1. Stabilize & labs → TLS prophylaxis
2. Staging + CNS eval
3. Start intensive regimen; add CNS prophylaxis

• Photomicrograph with 'starry‑sky' (tingible‑body macrophages)
• Child with jaw mass (endemic) vs teen with RLQ mass (sporadic)