Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.
Burkitt's vs non-Burkitt's small noncleaved-cell lymphoma. Is there a real difference? (Meeting abstract).
Lymphoma: the next questions. April 2-4, 1992, Orlando, FL, 1992.. Unique Identifier : AIDSLINE ICDB/93690615 Pugh WC; Dept. of Pathology, MD Anderson Cancer Center, Houston, TX
Abstract:
Several studies have sought to attribute clinical relevance to the distinction between Burkitt's and non-Burkitt's, or Burkitt's-like, forms of small noncleaved-cell lymphoma. Histologic criteria used in differentiating the two include (1) variation in nuclear size and shape, (2) prominence of nucleoli, and (3) pleomorphism and multinucleation, all of which are considered to indicate a diagnosis of small noncleaved-cell lymphoma of non-Burkitt's type. The application of these criteria is in many instances somewhat subjective, and cases morphologically borderline between Burkitt's and non-Burkitt's lymphoma, on the one hand, and between non-Burkitt's lymphoma and large cell lymphoma, on the other, exist even in optimally processed tissue. The latter distinction has proven to be particularly problematic in the HIV+ population, where cases having all the morphologic and kinetic attributes of small noncleaved-cell lymphoma frequently exhibit large cell morphology if conventional size criteria are rigorously applied. Given this degree of inherent subjectivity, exacerbated by differences in tissue fixation, it is not surprising that a consistent clinical profile of these two variants has not emerged. Nonetheless, most studies have documented a younger mean age (10-15 vs 40-50 yr) and a higher incidence of abdominal (especially gastrointestinal) and extranodal involvement in patients with Burkitt's lymphoma. While earlier series indicated a poorer survival in patients with non-Burkitt's lymphoma, recent studies based on more aggressive treatment regimens have shown no apparent difference in survival in children with Burkitt's and non-Burkitt's lymphoma, and a higher mortality in adults regardless of subclassification. Significant prognostic factors, in addition to age, include tumor burden, resectability, and serum LDH levels. In sum, the histologic boundary between small noncleaved-cell lymphomas of Burkitt's and non-Burkitt's type is not well-defined. In light of the poor inter- and intraobserver reproducibility in classification and the results of current clinical trials, routine attempts at distinction do not appear justified.
Keywords: Adult Burkitt's Lymphoma/COMPLICATIONS/*PATHOLOGY Cell Nucleolus Cell Nucleus Human HIV Infections/COMPLICATIONS Lymphoma, Small Noncleaved-Cell/COMPLICATIONS/*PATHOLOGY Middle Age ABSTRACT 930830
M9380842
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Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.
