Zhang XX, Xu J, Jiang T, Lu Y. Diagnosis and treatment of primary gastrointestinal Burkitt-like lymphoma in adults.
Shijie Huaren Xiaohua Zazhi 2016;
24:612-617. [DOI:
10.11569/wcjd.v24.i4.612]
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Abstract
AIM: To investigate the epidemiological and clinicopathological characteristics, diagnosis and treatment of primary gastrointestinal Burkitt-like lymphoma in adults.
METHODS: Relevant articles published since 1995 were retrieved in 15 English databases such as MEDLINE/PubMed, Web of Science, Directory of Open Access Journals (DOAJ) and SpringerLink and in China National Knowledge Infrastructure (CNKI) database. Data of six patients with primary gastrointestinal Burkitt-like lymphoma were obtained from six articles.
RESULTS: Four cases of adult primary gastrointestinal Burkitt-like lymphoma were from East Asia (Japan and China, 66.7%). All six patients were male with an average age of 57.6 years. Two cases occurred in the ileocecum, one in the stomach, one in the hepatic flexure of the colon, one in the terminal ileum, and one in the stomach and small intestine simultaneously. Four cases were admitted to the hospital because of abdominal mass, along with B symptoms: weight loss in four cases and fatigue in two cases. All patients underwent alimentary endoscopy (CT scan in 5 cases and B-ultrasound in 3 cases). Four cases underwent surgery, 5 cases underwent combined chemotherapy, and 3 cases underwent surgery plus postoperative chemotherapy. One case died within 1 year, and one case was followed for 5 years and is still alive. Immunohistochemically, CD20 and CD10 staining was positive in 4 cases, Ki-67 staining positive in 3 cases, Bcl-2 staining negative in 3 cases, CD23 and CD5 staining negative in 2 cases.
CONCLUSION: Adult primary gastrointestinal Burkitt-like lymphoma is a highly malignant non-Hodgkin's lymphoma and is extremely rare clinically with rapid development and high mortality. Its clinical manifestations are non-specific, so comprehensive examination should be conducted to confirm the diagnosis before clinical intervention. Final diagnosis still relies on fine-needle aspiration biopsy or surgical excision biopsy. Surgical treatment and multi-drug combination adjuvant chemotherapy postoperatively should be implemented as soon as possible after making a diagnosis. Clinicians should raise their awareness of the disease and pay more attention to the diagnosis and treatment of the disease, which could improve the outcome of the patients.
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