Burkitt lymphoma symptoms and diagnosis

• Burkitt lymphoma often develops in the stomach area (tummy) and bowel, causing symptoms such as tummy pain and nausea.
• Other symptoms can include swollen lymph nodes (glands), night sweats and unexplained weight loss.
• The main way to diagnose Burkitt lymphoma is through a small procedure called a biopsy.
• You will also have tests and scans to work out the stage of lymphoma and to help plan your treatment.

Burkitt lymphoma symptoms mainly depend on where in the body the lymphoma cells collect.

Symptoms of Burkitt lymphoma usually develop quickly. They can start or get worse in just a few days.

Burkitt lymphoma often grows in the stomach area (tummy) and bowel.

Symptoms can include:

• stomach (tummy) or back pain
• nausea (feeling sick) or being sick
• diarrhoea
• tummy swelling.

If the lymphoma is in the bone marrow (the spongy tissue inside some of our bones where blood cells are made), symptoms can include:

• bruising and bleeding easily, because of low blood cells called platelets
• higher risk of infection, because of low white blood cells (neutropenia)

Lymphoma cells can collect in your lymph nodes (glands), causing them to swell into lumps. These can be in your neck, armpit or groin.  The cells can also collect in other areas of your body, such as your liver and spleen. If these lumps of lymphoma are large, this is usually referred to as bulky disease.

Some people may also have symptoms that doctors call B symptoms. These often occur together. B symptoms are:

• night sweats that soak your clothes and bedding
• high temperatures (fever) that come and go with no obvious cause
• unexplained weight loss – usually more than 10% of your body weight over 6 months.

It is important to tell your hospital team if you have B symptoms. This helps them to stage your lymphoma and plan your treatment.

If your doctor thinks you have Burkitt lymphoma, they'll arrange tests to confirm the diagnosis and get more information to help them plan your treatment. We have more information about the tests below:

A doctor takes a sample of tissue from the affected area such as a swollen lymph node or a sample of bone marrow during a small procedure or operation.

This is usually done under a local anaesthetic (you’re awake and the area is numbed). In some cases, if the area cannot be reached easily, you may have a general anaesthetic (where you’re asleep). A specialist doctor then looks at the cells or tissue under a microscope.

A biopsy is the only way to confirm a diagnosis of Burkitt lymphoma.

You will have tests to see if the lymphoma has developed in other parts of your body. This is called staging. You will also have tests to help plan your treatment. Tests may include:

• a physical examination of any lumps
• blood tests such as a full blood count
• CT scans, PET scans, MRI scans and nuclear medicine renal scans
• a lumbar puncture test, to see if there are lymphoma cells in your spinal fluid
• an echocardiogram.

While waiting for test results can be a worrying time, the tests are important for planning your treatment. We have more information about tests and scans.

Doctors may test a sample of your blood or tissue to look for certain genetic changes found in Burkitt lymphoma cells.

These genetic changes are not the kind that you can pass down to children – they happen during your lifetime. We have more information about genetic testing.

Doctors use a process called staging to see where in the body the lymphoma is and if it has spread. This helps to plan your treatment.

The stages range from Stage 1 to Stage 4. In Stage 1 the lymphoma cells are in one lymph node or one group of lymph nodes, in one part of your body.

Stage 4 is when the lymphoma is most widespread to the lymph nodes and organs or bone marrow.

Health professionals add the letter A or B to the lymphoma stage to indicate whether you have certain symptoms. If the only symptoms you have are swollen lymph nodes, A is put after your stage. B is put after the lymphoma stage if there are additional symptoms such as weight loss, fever or night sweats.

They may also use the letter E (extranodal) to indicate whether the lymphoma is outside the lymph nodes and other letters to indicate where the lymphoma first developed.

You may hear the terms early stage (stages 1 and 2) and advanced stage (stages 3 and 4). Having a higher number (3 or 4) or more than one letter does not mean that the treatment will not be as effective.

Staging helps your hospital team choose the right treatment for you.

You may come across the terms low risk and high risk Burkitt lymphoma. This ‘risk’ can help your hospital team to plan your treatment. Test results can help them to decide if you have high risk or low risk Burkitt lymphoma. Most people will need intensive treatment at the time of diagnosis and are therefore likely to be considered high risk.

Your hospital team look at factors such as:

• how the lymphoma affects your well-being
• whether the lymphoma is outside the lymph nodes (extranodal)
• the stage and size of the lymphoma
• whether the lymphoma affects your central nervous system or CNS (brain and spinal cord).

Your hospital team will help you understand your staging and risk.