What is the role of surgery in the treatment of Burkitt lymphoma/Burkitt-like lymphoma (BL/BLL)?

Updated: Dec 20, 2019
  • Author: Ali H Kanbar, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

In current clinical practice, effective and durable responses are observed with combination chemotherapy, obviating the role of surgical debulking. Historically, most patients with Burkitt lymphoma who presented with large masses, particularly abdominal disease, underwent an exploratory laparotomy, at which time an effort was made to debulk as well.

With newer, sophisticated interventional radiology approaches, an adequate diagnosis can be reached in almost all patients without major surgical intervention. Palliative surgery is considered only for patients with obstruction who cannot begin chemotherapy immediately.

Tracheotomy is indicated if the patient's airway is compromised from the physical pressure of a large tumor mass.

Exploratory laparotomy may be performed for bowel obstruction (often before the diagnosis is made). Patients with uncontrolled gastrointestinal bleeding may also need exploratory laparotomy or endoscopic procedures for hemostasis.

Pericardiocentesis is indicated for patients presenting with cardiac tamponade.

Paracentesis is indicated if large ascites is one of the presenting complaints.

An excisional lymph node biopsy is usually necessary to reach an accurate diagnosis.

A semi-permanent intravenous catheter such as a peripherally inserted central catheter (PICC) line or medicine port should be arranged with interventional radiology or surgery to aid administration of chemotherapy, medications, and blood products and for fluid management.


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