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Ward BJH, Schaal DL, Nkadi EH, Scott RS. EBV Association with Lymphomas and Carcinomas in the Oral Compartment. Viruses 2022; 14:v14122700. [PMID: 36560704 PMCID: PMC9783324 DOI: 10.3390/v14122700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022] Open
Abstract
Epstein-Barr virus (EBV) is an oncogenic human herpesvirus infecting approximately 90% of the world's population. The oral cavity serves a central role in the life cycle, transmission, and pathogenesis of EBV. Transmitted to a new host via saliva, EBV circulates between cellular compartments within oral lymphoid tissues. Epithelial cells primarily support productive viral replication, while B lymphocytes support viral latency and reactivation. EBV infections are typically asymptomatic and benign; however, the latent virus is associated with multiple lymphomas and carcinomas arising in the oral cavity. EBV association with cancer is complex as histologically similar cancers often test negative for the virus. However, the presence of EBV is associated with distinct features in certain cancers. The intrinsic ability of EBV to immortalize B-lymphocytes, via manipulation of survival and growth signaling, further implicates the virus as an oncogenic cofactor. A distinct mutational profile and burden have been observed in EBV-positive compared to EBV-negative tumors, suggesting that viral infection can drive alternative pathways that converge on oncogenesis. Taken together, EBV is also an important prognostic biomarker that can direct alternative therapeutic approaches. Here, we discuss the prevalence of EBV in oral malignancies and the EBV-dependent mechanisms associated with tumorigenesis.
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Abstract
Despite the significant advances made in our understanding of cancer and how to treat it over the last hundred years, there are wide global disparities in access to cancer care and in who gets to benefit from cutting-edge cancer research.
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Soyland DJ, Thanel PF, Sievers ME, Wagner K, Vuong SM. Primary epidural sporadic Burkitt lymphoma in a 3-year-old: Case report and literature review. Surg Neurol Int 2022; 13:106. [PMID: 35399880 PMCID: PMC8986637 DOI: 10.25259/sni_1172_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Burkitt lymphoma (BL) is a common tumor of childhood that usually arises in the abdomen or pelvis in its sporadic form. In a minority of cases, BL can present with CNS involvement, usually as a secondary site. Rarely, BL can arise primarily in the epidural space and present with back pain, or less commonly, acute myelopathy. This presentation is a surgical emergency and requires vigilant management. Case Description: We describe a case of pediatric BL arising primarily within the epidural space and presenting with progressive difficulty walking in a 3-year-old boy. Progression to complete inability to walk, absent lower extremity deep tendon reflexes, and new urinary incontinence prompted MRI of the spine, which showed a lesion extending from T5 to T10 and wrapping around the anterior and posterior portions of the spine with evidence of spinal cord compression. The patient underwent decompressive laminectomies from T5 to T10 and partial debulking of the posterior portions of the tumor. Microscopic examination showed a prominent “starry sky” pattern with abundant mitotic figures. Immunohistochemistry confirmed the diagnosis of BL. The patient is 10 months post-op and continues to undergo chemotherapy with partial neurologic improvement. He was free of recurrence 10 months post-operative. Conclusion: This appears to be the youngest described patient presenting with acute myelopathy in primary paraspinal BL. Management should include surgical decompression of the spinal cord followed by one of the various described chemotherapeutic regimens. Preoperative staging and neurologic function correlate with prognosis.
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Affiliation(s)
- Dallas J. Soyland
- Department of Neurosurgery, Sanford School of Medicine, Sioux Falls, South Dakota, United States
| | - Paul F. Thanel
- Department of Neurosurgery, Sanford School of Medicine, Sioux Falls, South Dakota, United States
| | - Meaghan E. Sievers
- Department of Neurosurgery, Sanford School of Medicine, Sioux Falls, South Dakota, United States
| | - Kayelyn Wagner
- Department of Pediatric Oncology, Sanford School of Medicine, Sioux Falls, South Dakota, United States
| | - Shawn M. Vuong
- Department of Neurosurgery, Sanford School of Medicine, Sioux Falls, South Dakota, United States
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Ranger-Rogez S. EBV Genome Mutations and Malignant Proliferations. Infect Dis (Lond) 2021. [DOI: 10.5772/intechopen.93194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The Epstein-Barr virus (EBV) is a DNA virus with a relatively stable genome. Indeed, genomic variability is reported to be around 0.002%. However, some regions are more variable such as those carrying latency genes and specially EBNA1, -2, -LP, and LMP1. Tegument genes, particularly BNRF1, BPLF1, and BKRF3, are also quite mutated. For a long time, it has been considered for this ubiquitous virus, which infects a very large part of the population, that particular strains could be the cause of certain diseases. However, the mutations found, in some cases, are more geographically restricted rather than associated with proliferation. In other cases, they appear to be involved in oncogenesis. The objective of this chapter is to provide an update on changes in viral genome sequences in malignancies associated with EBV. We focused on describing the structure and function of the proteins corresponding to the genes mentioned above in order to understand how certain mutations of these proteins could increase the tumorigenic character of this virus. Mutations described in the literature for these proteins were identified by reporting viral and/or cellular functional changes as they were described.
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Dillon M, Lopez A, Lin E, Sales D, Perets R, Jain P. Progress on Ras/MAPK Signaling Research and Targeting in Blood and Solid Cancers. Cancers (Basel) 2021; 13:cancers13205059. [PMID: 34680208 PMCID: PMC8534156 DOI: 10.3390/cancers13205059] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary The Ras-Raf-MEK-ERK signaling pathway is responsible for regulating cell proliferation, differentiation, and survival. Overexpression and overactivation of members within the signaling cascade have been observed in many solid and blood cancers. Research often focuses on targeting the pathway to disrupt cancer initiation and progression. We aimed to provide an overview of the pathway’s physiologic role and regulation, interactions with other pathways involved in cancer development, and mutations that lead to malignancy. Several blood and solid cancers are analyzed to illustrate the impact of the pathway’s dysregulation, stemming from mutation or viral induction. Finally, we summarized different approaches to targeting the pathway and the associated novel treatments being researched or having recently achieved approval. Abstract The mitogen-activated protein kinase (MAPK) pathway, consisting of the Ras-Raf-MEK-ERK signaling cascade, regulates genes that control cellular development, differentiation, proliferation, and apoptosis. Within the cascade, multiple isoforms of Ras and Raf each display differences in functionality, efficiency, and, critically, oncogenic potential. According to the NCI, over 30% of all human cancers are driven by Ras genes. This dysfunctional signaling is implicated in a wide variety of leukemias and solid tumors, both with and without viral etiology. Due to the strong evidence of Ras-Raf involvement in tumorigenesis, many have attempted to target the cascade to treat these malignancies. Decades of unsuccessful experimentation had deemed Ras undruggable, but recently, the approval of Sotorasib as the first ever KRas inhibitor represents a monumental breakthrough. This advancement is not without novel challenges. As a G12C mutant-specific drug, it also represents the issue of drug target specificity within Ras pathway; not only do many drugs only affect single mutational profiles, with few pan-inhibitor exceptions, tumor genetic heterogeneity may give rise to drug-resistant profiles. Furthermore, significant challenges in targeting downstream Raf, especially the BRaf isoform, lie in the paradoxical activation of wild-type BRaf by BRaf mutant inhibitors. This literature review will delineate the mechanisms of Ras signaling in the MAPK pathway and its possible oncogenic mutations, illustrate how specific mutations affect the pathogenesis of specific cancers, and compare available and in-development treatments targeting the Ras pathway.
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Greenspan JS, Challacombe SJ. The impact of the world Workshops on oral health and disease in HIV and AIDS (1988-2020). Oral Dis 2020; 26 Suppl 1:3-8. [PMID: 32862530 DOI: 10.1111/odi.13385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The first World Workshop on Oral AIDS was held in San Diego in 1988, organized by John and Deborah Greenspan who saw the need and advantages of getting together all those health workers globally who were interested in oral aspects of HIV with a common purpose of advancing the field collectively and collaboratively. Since that time and over the following 30 years, World Workshops on oral HIV have been held every four years or so. The aims of the first and all subsequent Workshops were to bring together clinicians and non-clinical scientists who have an interest in the oral manifestations of HIV disease, to share worldwide perspectives, knowledge and understanding of oral health and disease in HIV infection, to agree on global definitions and classifications of oral diseases and to identify research needs taking account of the worldwide perspectives and opportunities. Thus, there have been clinical science, social science and basic science aspects of each World Workshop. The Workshops have achieved their aims and have had impact in all three fields, leading to robust research agendas, changes in national HIV policies and international collaborations. They have led to policy declarations of access to oral care as a basic human right for both HIV-positive and HIV-negative individuals and advancing the rights of all HIV-positive healthcare workers to perform clinical practice.
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Affiliation(s)
- John S Greenspan
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, CA, USA
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Development of a nano-drug delivery system based on mesoporous silica and its anti-lymphoma activity. APPLIED NANOSCIENCE 2020. [DOI: 10.1007/s13204-020-01465-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Peprah S, Ogwang MD, Kerchan P, Reynolds SJ, Tenge CN, Were PA, Kuremu RT, Wekesa WN, Masalu N, Kawira E, Kinyera T, Otim I, Legason ID, Nabalende H, Dhudha H, Mumia M, Ayers LW, Biggar RJ, Bhatia K, Goedert JJ, Mbulaiteye SM. Mean platelet counts are relatively decreased with malaria but relatively increased with endemic Burkitt Lymphoma in Uganda, Tanzania, and Kenya. Br J Haematol 2020; 190:772-782. [PMID: 32395868 DOI: 10.1111/bjh.16700] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/01/2020] [Accepted: 04/07/2020] [Indexed: 12/28/2022]
Abstract
Platelet counts are decreased in Plasmodium falciparum malaria, which is aetiologically linked with endemic Burkitt lymphoma (eBL). However, the pattern of platelet counts in eBL cases is unknown. We studied platelet counts in 582 eBL cases and 2 248 controls enrolled in a case-control study in Uganda, Tanzania and Kenya (2010-2016). Mean platelet counts in controls or eBL cases with or without malaria-infection in controls versus eBLcases were compared using Student's t-test. Odds ratios (ORs) and two-sided 95% confidence intervals (95% CIs) were estimated using multiple logistic regression, controlling for age, sex, haemoglobin and white blood cell counts. Platelets were decreased with malaria infection in the controls [263 vs. 339 × 109 platelets/l, P < 0·0001; adjusted OR (aOR) = 3·42, 95% CI: 2·79-4·18] and eBL cases (314 vs. 367 × 109 platelets/l, P-value = 0·002; aOR = 2·36, 95% CI: 1·49-3·73). Unexpectedly, platelets were elevated in eBL cases versus controls in overall analyses (mean: 353 vs. 307 × 109 platelets/l, P < 0·0001; aOR = 1·41; 95% CI: 1·12-1·77), and when restricted to malaria-positive (mean 314 vs. 263 × 109 platelets/l, P < 0·0001; OR = 2·26; 95% CI: 1·56-3·27) or malaria-negative (mean 367 vs. 339 × 109 platelets/l, P < 0·001; OR = 1·46; 95% CI: 1·17-1·83) subjects. Platelets were decreased with malaria infection in controls and eBL cases but elevated with eBL.
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Affiliation(s)
- Sally Peprah
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Martin D Ogwang
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, St. Mary's Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Patrick Kerchan
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, Kuluva Hospital, Arua & African Field Epidemiology Network, Kuluva, Kampala, Uganda
| | - Steven J Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Constance N Tenge
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, Moi University College of Health Sciences, Eldoret, Kenya
| | - Pamela A Were
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, Academic Model Providing Access To Healthcare, Eldoret, Kenya
| | - Robert T Kuremu
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, Moi University College of Health Sciences, Eldoret, Kenya
| | - Walter N Wekesa
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, Moi University College of Health Sciences, Eldoret, Kenya
| | - Nestory Masalu
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, Bugando Medical Center, Mwanza, Tanzania
| | - Esther Kawira
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, Shirati Health, Education, and Development Foundation, and Shirati Hospital, Shirati, Tanzania
| | - Tobias Kinyera
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, St. Mary's Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Isaac Otim
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, St. Mary's Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Ismail D Legason
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, Kuluva Hospital, Arua & African Field Epidemiology Network, Kuluva, Kampala, Uganda
| | - Hadijah Nabalende
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, St. Mary's Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Herry Dhudha
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, Shirati Health, Education, and Development Foundation, and Shirati Hospital, Shirati, Tanzania
| | - Mediatrix Mumia
- EpideMiology of Burkitt Lymphoma in East African Children and Minors Study, Academic Model Providing Access To Healthcare, Eldoret, Kenya
| | - Leona W Ayers
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | - Robert J Biggar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kishor Bhatia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - James J Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sam M Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Burkitt's Lymphoma of the Base of the Tongue: A Case Report and Review of the Literature. EAR, NOSE & THROAT JOURNAL 2019. [DOI: 10.1177/014556130708600617] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Burkitt's lymphoma is a highly aggressive, mature B cell non-Hodgkin's lymphoma that is rare outside Africa. We report a case of Burkitt's lymphoma presenting as a rapidly expanding tongue-base mass that caused airway obstruction in an 80-year-old Palestinian man living in California. According to our review of the literature, this is only the third reported case of Burkitt's lymphoma arising in the base of the tongue. We also discuss the incidence, epidemiology, genetics, prognosis, and treatment of this malignancy. Because Burkitt's lymphoma is one of the fastest-growing tumors in humans, rapid diagnosis and treatment are important. Treatment involves brief-duration, high-intensity chemotherapy and central nervous system prophylaxis. It is important for the otolaryngologist to recognize this disease and to understand the steps necessary to treat this aggressive tumor.
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Liao HM, Liu H, Lei H, Li B, Chin PJ, Tsai S, Bhatia K, Gutierrez M, Epelman S, Biggar RJ, Nkrumah F, Neequaye J, Ogwang MD, Reynolds SJ, Lo SC, Mbulaiteye SM. Frequency of EBV LMP-1 Promoter and Coding Variations in Burkitt Lymphoma Samples in Africa and South America and Peripheral Blood in Uganda. Cancers (Basel) 2018; 10:E177. [PMID: 29865259 PMCID: PMC6024959 DOI: 10.3390/cancers10060177] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 05/29/2018] [Indexed: 12/30/2022] Open
Abstract
Epstein-Barr virus (EBV) is linked to several cancers, including endemic Burkitt lymphoma (eBL), but causal variants are unknown. We recently reported novel sequence variants in the LMP-1 gene and promoter in EBV genomes sequenced from 13 of 14 BL biopsies. Alignments of the novel sequence variants for 114 published EBV genomes, including 27 from BL cases, revealed four LMP-1 variant patterns, designated A to D. Pattern A variant was found in 48% of BL EBV genomes. Here, we used PCR-Sanger sequencing to evaluate 50 additional BL biopsies from Ghana, Brazil, and Argentina, and peripheral blood samples from 113 eBL cases and 115 controls in Uganda. Pattern A was found in 60.9% of 64 BL biopsies evaluated. Compared to PCR-negative subjects in Uganda, detection of Pattern A in peripheral blood was associated with eBL case status (odds ratio [OR] 31.7, 95% confidence interval: 6.8⁻149), controlling for relevant confounders. Variant Pattern A and Pattern D were associated with eBL case status, but with lower ORs (9.7 and 13.6, respectively). Our results support the hypothesis that EBV LMP-1 Pattern A may be associated with eBL, but it is not the sole associated variant. Further research is needed to replicate and elucidate our findings.
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Affiliation(s)
- Hsiao-Mei Liao
- Center for Biologics Evaluation and Research, Food and Drug Administration, White Oak, MD 20993, USA.
| | - Hebing Liu
- Center for Biologics Evaluation and Research, Food and Drug Administration, White Oak, MD 20993, USA.
| | - Heiyan Lei
- Center for Biologics Evaluation and Research, Food and Drug Administration, White Oak, MD 20993, USA.
| | - Bingjie Li
- Center for Biologics Evaluation and Research, Food and Drug Administration, White Oak, MD 20993, USA.
| | - Pei-Ju Chin
- Center for Biologics Evaluation and Research, Food and Drug Administration, White Oak, MD 20993, USA.
| | - Shien Tsai
- Center for Biologics Evaluation and Research, Food and Drug Administration, White Oak, MD 20993, USA.
| | | | - Marina Gutierrez
- Laboratorio Stamboulian, Laboratorio Stamboulian, Buenos Aires 1414, Argentina.
| | - Sidnei Epelman
- Department of Pediatric Oncology, St Marcelina Hospital, Sao Paolo 08270-070, Brazil.
| | - Robert J Biggar
- Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, MD 20892, USA.
| | - Francis Nkrumah
- Noguchi Memorial Institute, Kor Le Bu University, P.O. Box LG 581 Legon, Accra, Ghana.
| | - Janet Neequaye
- Department of Child Health, University of Ghana, P.O. Box LG 25 Legon, Accra, Ghana.
| | - Martin D Ogwang
- EMBLEM Study, St. Mary's Hospital, Lacor, P.O. Box 180, Gulu, Uganda.
| | - Steven J Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, USA.
| | - Shyh-Ching Lo
- Center for Biologics Evaluation and Research, Food and Drug Administration, White Oak, MD 20993, USA.
| | - Sam M Mbulaiteye
- Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, MD 20892, USA.
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Minimally Invasive Treatment of Sporadic Burkitt's Lymphoma Causing Ileocaecal Invagination. Case Rep Surg 2018; 2018:6265182. [PMID: 29854542 PMCID: PMC5952441 DOI: 10.1155/2018/6265182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 04/04/2018] [Indexed: 12/24/2022] Open
Abstract
Introduction Primary NHL (non-Hodgkin lymphoma) of the colon represents only 0.2% to 1.2% of all colonic malignancies. Burkitt's lymphoma (BL) is usually a disease reported in children and young people, most of them associated with EBV or HIV infection. We describe a rare case of intestinal obstruction due to sporadic Burkitt's lymphoma causing ileocaecal invagination explaining our experience Methods. A 31-year-old man presented with diffuse colic pain and weight loss. Clinical examination revealed an abdominal distension with pain in the right iliac fossa. Colonoscopy documented a caecal large lesion with ulcerated mucosa. Computed tomography (CT) have shown a 60 × 50 mm right colic parietal lesion with signs of ileocolic intussusception. Results Laparoscopic right hemicolectomy was performed. Postoperative period was uneventful. CD20+ high-grade B-cell Burkitt's lymphoma was confirmed by immunohistochemistry (CD20+, CD79+, and CD10+) and FISH test (t (8;14) (q24; q32). The patient was subsequently treated with adjuvant combination chemotherapy (Hyper-CVAD) and is alive and disease-free at 8 months follow-up. Discussion Adult sporadic Burkitt's lymphoma (BL) causing intestinal obstruction due to ileocaecal intussusception is an extremely rare occurrence and a diagnostic dilemma. Despite the surgical approach is selected based on patient's conditions and surgeon's expertise, minimally invasive method could be preferred.
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Rahman SI, Fernandes JK, Gill MK. Relapsed Burkitt Lymphoma Presenting as an Isolated Infiltrative Optic Neuropathy. Neuroophthalmology 2016; 40:133-135. [PMID: 27928397 DOI: 10.3109/01658107.2016.1153113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 02/08/2016] [Accepted: 02/08/2016] [Indexed: 11/13/2022] Open
Abstract
We report a case of relapsed sporadic Burkitt lymphoma (BL) presenting as an isolated infiltrative optic neuropathy. This is a single-patient, retrospective case report of a patient seen by the ophthalmology service at our institution. To our knowledge, our case is the first to report isolated infiltrative optic neuropathy associated with sporadic BL as the sole manifestation of recurrence. The possibility of disease relapse should be considered for patients with a history of lymphoreticular malignancy who present with acute visual symptoms suggestive of optic neuropathy.
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Affiliation(s)
- Shiraaz I Rahman
- Department of Ophthalmology, Northwestern University , Chicago, Illinois, USA
| | - Joshua K Fernandes
- Department of Ophthalmology, Northwestern University , Chicago, Illinois, USA
| | - Manjot K Gill
- Department of Ophthalmology, Northwestern University , Chicago, Illinois, USA
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13
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Lei H, Li T, Li B, Tsai S, Biggar RJ, Nkrumah F, Neequaye J, Gutierrez M, Epelman S, Mbulaiteye SM, Bhatia K, Lo SC. Epstein-Barr virus from Burkitt Lymphoma biopsies from Africa and South America share novel LMP-1 promoter and gene variations. Sci Rep 2015; 5:16706. [PMID: 26593963 PMCID: PMC4655394 DOI: 10.1038/srep16706] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 10/19/2015] [Indexed: 11/20/2022] Open
Abstract
Epstein Barr virus (EBV) sequence variation is thought to contribute to Burkitt lymphoma (BL), but lack of data from primary BL tumors hampers efforts to test this hypothesis. We directly sequenced EBV from 12 BL biopsies from Ghana, Brazil, and Argentina, aligned the obtained reads to the wild-type (WT) EBV reference sequence, and compared them with 100 published EBV genomes from normal and diseased people from around the world. The 12 BL EBVs were Type 1. Eleven clustered close to each other and to EBV from Raji BL cell line, but away from 12 EBVs reported from other BL-derived cell lines and away from EBV from NPC and healthy people from Asia. We discovered 23 shared novel nucleotide-base changes in the latent membrane protein (LMP)-1 promoter and gene (associated with 9 novel amino acid changes in the LMP-1 protein) of the 11 BL EBVs. Alignment of this region for the 112 EBV genomes revealed four distinct patterns, tentatively termed patterns A to D. The distribution of BL EBVs was 48%, 8%, 24% and 20% for patterns A to D, respectively; the NPC EBV's were Pattern B, and EBV-WT was pattern D. Further work is needed to investigate the association between EBV LMP-1 patterns with BL.
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Affiliation(s)
- Haiyan Lei
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Tianwei Li
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Bingjie Li
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Shien Tsai
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | | | | | - Janet Neequaye
- Department of Child Health, University of Ghana, Accra, Ghana
| | | | - Sidnei Epelman
- Department of Pediatric Oncology, St Marcelina Hospital, Sao Paolo, Brazil
| | - Sam M. Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Kishor Bhatia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Shyh-Ching Lo
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
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Huang S, Suhrland MJ, Gritz D. Recurrent Immunodeficiency-Associated Burkitt Lymphoma Presenting as Severe Anterior Uveitis. Ocul Oncol Pathol 2015; 2:62-5. [PMID: 27171824 DOI: 10.1159/000439054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 07/21/2015] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To report a case of recurrent immunodeficiency-associated Burkitt lymphoma (BL) that initially presented as severe anterior uveitis. METHODS Case report. RESULTS To our knowledge, this is the first reported case of isolated anterior uveitis related to immunodeficiency-associated BL. A 34-year-old African American woman with a history of HIV and BL in remission presented with unilateral anterior uveitis. Histopathologic study of an aqueous humor specimen was consistent for BL. CONCLUSION The patient's initial presentation masqueraded as anterior uveitis, but her condition rapidly progressed with significant central nervous system involvement. Ocular involvement of immunodeficiency-associated BL is rare, with isolated anterior uveitis being even rarer. This must be kept in mind in the differential diagnosis for any patient with immunodeficiency, especially with a history of previous BL.
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Affiliation(s)
- Susan Huang
- Departments of Ophthalmology, Bronx, N.Y., USA
| | - Mark J Suhrland
- Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, N.Y., USA
| | - David Gritz
- Departments of Ophthalmology, Bronx, N.Y., USA
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Simbiri KO, Biddle J, Kinyera T, Were PA, Tenge C, Kawira E, Masalu N, Sumba PO, Lawler-Heavner J, Stefan CD, Buonaguro FM, Robinson D, Newton R, Harford J, Bhatia K, Mbulaiteye SM. Burkitt lymphoma research in East Africa: highlights from the 9(th) African organization for research and training in cancer conference held in Durban, South Africa in 2013. Infect Agent Cancer 2014; 9:32. [PMID: 25686906 PMCID: PMC4163050 DOI: 10.1186/1750-9378-9-32] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 08/18/2014] [Indexed: 11/10/2022] Open
Abstract
A one-day workshop on Burkitt lymphoma (BL) was held at the 9(th) African Organization for Research and Training in Cancer (AORTIC) conference in 2013 in Durban, South Africa. The workshop featured 15 plenary talks by delegates representing 13 institutions that either fund or implement research on BL targeting AORTIC delegates primarily interested in pediatric oncology. The main outcomes of the meeting were improved sharing of knowledge and experience about ongoing epidemiologic BL research, BL treatment in different settings, the role of cancer registries in cancer research, and opportunities for African scientists to publish in scientific journals. The idea of forming a consortium of BL to improve coordination, information sharing, accelerate discovery, dissemination, and translation of knowledge and to build capacity, while reducing redundant efforts was discussed. Here, we summarize the presentations and discussions from the workshop.
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Affiliation(s)
- Kenneth O Simbiri
- State University of New York (SUNY) Upstate Medical University, New York, NY, USA
| | - Joshua Biddle
- University of California at San Francisco, San Francisco, CA, USA
| | | | | | | | - Esther Kawira
- EMBLEM Study, Shirati Health Education and Development (SHED) Foundation, Shirati, Tanzania
| | | | | | | | | | | | | | - Robert Newton
- University of York, Heslington, York, United Kingdom/Medical Research Council/International Agency for Research on Cancer (IARC), Lyon, France
| | - Joe Harford
- National Institutes of Health/NCI/DCEG, 9609 Medical Center Dr, Rm. 6E118 MSC 9704, Bethesda, MD 20892-9704, USA
| | - Kishor Bhatia
- National Institutes of Health/NCI/DCEG, 9609 Medical Center Dr, Rm. 6E118 MSC 9704, Bethesda, MD 20892-9704, USA
| | - Sam M Mbulaiteye
- National Institutes of Health/NCI/DCEG, 9609 Medical Center Dr, Rm. 6E118 MSC 9704, Bethesda, MD 20892-9704, USA
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Aslan G. Unusual presentation of sporadic Burkitt's lymphoma originating from the nasal septum: a case report. J Med Case Rep 2013; 7:60. [PMID: 23497670 PMCID: PMC3599746 DOI: 10.1186/1752-1947-7-60] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 01/25/2013] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Burkitt's lymphoma is a highly aggressive, small, non-cleaved B-cell non-Hodgkin's lymphoma. In the sporadic form of the disease that occurs in non-endemic areas around the world, most commonly in developed countries, patients usually present with an abdominal mass that frequently involves the ileocecal region of the bowel; ocular or orbital involvement is rare. Primary disease of the sinuses is uncommon and, to the best of our knowledge, that of the anterior septum has never been described. We report the diagnosis and successful management of Burkitt's lymphoma originating from the nasal septum in a male patient. CASE PRESENTATION An otherwise healthy 78-year-old Caucasian man who did not smoke cigarettes was admitted to our Ear, Nose and Throat outpatient clinic with the complaint of nasal obstruction due to left-sided nasal septal thickening. Paranasal computerized tomography revealed a well-circumscribed solid mass originating from his anterior nasal septum and obstructing his airway. The final diagnosis of Burkitt's lymphoma was verified by immunohistochemical studies. Our patient had a good clinical outcome after chemoradiotherapy, with no problems reported to date in the second year of follow-up. CONCLUSION We provide what we believe to be the first report of a case of sporadic Burkitt's lymphoma involving the nasal septum, and describe the efficacy of first-line chemotherapy. Being an original case report with broader clinical impact across more than one area of medicine, this case presentation has the potential to significantly advance our understanding of Burkitt's lymphoma and we emphasize the need to include this disease in the differential diagnosis of patients presenting with a nasal septal mass.
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Affiliation(s)
- Gaffar Aslan
- Department of Otorhinolaryngology-Head and Neck Surgery, Istanbul Bilim University Faculty of Medicine, Istanbul, Turkey.
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Abstract
Infectious mononucleosis (IM) is one of the representative, usually benign, acute diseases associated with primary Epstein-Barr virus (EBV) infection. IM is generally self-limiting and is characterized mostly by transient fever, lymphadenopathy and hepatosplenomegaly. However, very rarely primary EBV infection results in severe or fatal conditions such as hemophagocytic lymphohistiocytosis together with fulminant hepatitis designated as severe or fatal IM or EBV-associated hemophagocytic lymphohistiocytosis alone. In addition, chronic EBV-associated diseases include Burkitt's lymphoma, undifferentiated nasopharyngeal carcinoma, Hodgkin lymphoma, T-cell lymphoproliferative disorder (LPD)/lymphoma, natural killer-cell LPD including leukemia or lymphoma, gastric carcinoma, pyothorax-associated lymphoma and senile B-cell LPD as well as chronic active EBV infection and LPD/lymphoma in patients with immunodeficiency. The number of chronic life-threatening diseases linked to the EBV infection is increasingly reported and many of these diseases have a poor prognosis. This review will focus on the historical, pathogenetic, diagnostic, therapeutic and prophylactic issues of EBV-associated life-threatening diseases.
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Kikuchi K, Inoue H, Miyazaki Y, Ide F, Matsuki E, Shigematu H, Okamoto S, Sakashita H, Kusama K. Adult sporadic burkitt lymphoma of the oral cavity: a case report and literature review. J Oral Maxillofac Surg 2012; 70:2936-43. [PMID: 22520562 DOI: 10.1016/j.joms.2012.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 02/15/2012] [Accepted: 02/15/2012] [Indexed: 02/04/2023]
Affiliation(s)
- Kentaro Kikuchi
- Division of Pathology, Department of Diagnostic & Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan.
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Okebe JU, Skoetz N, Meremikwu MM, Richards S. Therapeutic interventions for Burkitt lymphoma in children. Cochrane Database Syst Rev 2011; 2011:CD005198. [PMID: 21735399 PMCID: PMC7390501 DOI: 10.1002/14651858.cd005198.pub3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Burkitt lymphoma (BL) is an important cancer found mostly in children but uncertainty remains as to the most effective form of management. In endemic areas, late-stage presentation as a result of delayed access to treatment compounds the situation. OBJECTIVES To assess the evidence for chemotherapy, surgery, radiotherapy and immunotherapy in the treatment of children with endemic BL. SEARCH STRATEGY We updated and re-ran the searches in the following electronic databases from the time of the first publication; the Cochrane Controlled Trials Register (CENTRAL) (Issue 1, 2011); MEDLINE (January 2011); EMBASE (January 2011); and the clinical trials registry (up to January 2011) to identify relevant trials. In addition, we also updated the search of the US clinical trials register for on-going and completed trials up to January 2011. We also updated the search terms and used the Cochrane filter for identifying randomised trials in MEDLINE. SELECTION CRITERIA We included randomised controlled trials (RCTs) of any duration. We included studies conducted in children with a confirmed diagnosis of BL. We did not restrict studies by geographical location or by language of publication. We considered any therapeutic intervention. The primary outcome was overall survival. DATA COLLECTION AND ANALYSIS Two review authors assessed studies for relevance. We assessed studies that met the entry criteria for study quality. We independently extracted data and entered the data into Review Manager (RevMan). In this update, two review authors independently assessed citations from the updated search and reviewed abstracts for relevance. MAIN RESULTS We included one new study in this update. In total, 13 trials involving 1824 participants met the inclusion criteria for this review however, data in usable format were only available in 10 trials (732 participants). Inadequate reporting of study methodology was a common feature of the trials preventing thorough assessment of study quality. We were unable to pool data for any of the outcomes due to the differences between the interventions assessed in the studies. Eight studies aimed to induce remission; overall survival did not differ significantly between treatment groups. Five studies aimed to maintain remission. In two out of three studies reporting survival, this was substantial but the difference was not statistically significant between treatment groups. Less aggressive treatment schedules appear to produce similar effects with less adverse event profiles. AUTHORS' CONCLUSIONS This review notes a preference in more recent studies for less aggressive care options for treatment of BL. However, the evidence for the relative effectiveness of interventions to treat BL is not strong as studies were small, underpowered and prone to both systematic and random error. We included one additional trial without change of conclusions.
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Affiliation(s)
| | - Nicole Skoetz
- University Hospital of CologneCochrane Haematological Malignancies Group, Department I of Internal MedicineKerpener Str. 62CologneGermany50924
| | - Martin M Meremikwu
- University of Calabar Teaching HospitalDepartment of PaediatricsPMB 1115CalabarCross River StateNigeria
| | - Sue Richards
- Oxford UniversityClinical Trials Services UnitWoodstock RoadOxfordUKOX2 6HE
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Carmody J, Misra RP, Langford MP, Byrd WA, Ditta L, Vekovius B, Texada DE. Orbital sporadic Burkitt lymphoma in an adult diabetic African American female and a review of adult orbital cases. Clin Ophthalmol 2011; 5:509-15. [PMID: 21573040 PMCID: PMC3090307 DOI: 10.2147/opth.s16751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Indexed: 11/23/2022] Open
Abstract
A case of sporadic Burkitt lymphoma (sBL) presenting with jaw and lid involvement in a diabetic adult African American female and a review of adult orbital Burkitt lymphoma cases are presented. Lid edema, visual loss, ophthalmoparesis, proptosis, and sinusitis progressed over 4 weeks despite antibiotic and steroid treatment. Upper lid biopsy histopathological evaluation and immunophenotyping revealed a homogenous mass of atypical CD10 and CD20-negative B-cells and tingible body macrophages yielding a "starry sky" appearance. Cytogenetic analysis detected a minor variant c-MYC translocation, but no Epstein-Barr virus RNA. Detection of multiple lesions prompted a diagnosis of stage IV disease that totally regressed following radiation and chemotherapy. Review results of the six adult orbital sBL cases support a poor prognosis and a heightened suspicion of variant CD10, CD20 and BCL6 positive sBL in adults presenting with jaw pain and rapidly progressive orbital symptoms, particularly in female, African American, and diabetic patients.
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Affiliation(s)
| | - Raghunath P Misra
- Department of Ophthalmology
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, LA, USA
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Kamulegeya A, Muwazi L, Kasaganki A, Rwenyonyi C, Kuteesa A. Trends in Burkitt's lymphoma: a three-decade retrospective study from Uganda. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.1752-248x.2010.01095.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wang SM, Huang FC, Wu CH, Ko SF, Lee SY, Hsiao CC. Ileocecal Burkitt's lymphoma presenting as ileocolic intussusception with appendiceal invagination and acute appendicitis. J Formos Med Assoc 2010; 109:476-9. [PMID: 20610150 DOI: 10.1016/s0929-6646(10)60080-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Revised: 03/08/2008] [Accepted: 08/25/2008] [Indexed: 01/21/2023] Open
Abstract
Intussusception is a common cause of abdominal pain in children. Although most cases are idiopathic, about 10% of cases have a pathologic lead point. Burkitt's lymphoma is not a common etiology. Burkitt's lymphoma might present primarily as intussusception in children but has rarely been associated with appendicitis. We report a case in which a 10-year-old obese boy who initially presented with acute appendicitis due to ileocolic intussusception with appendiceal invagination. He underwent one-trocar laparoscopy and antibiotic treatment. The symptoms recurred 10 days after discharge. Colonoscopy disclosed ileocecal Burkitt's lymphoma as the pathological lead point. This case emphasizes the importance of the age of the patient and the anatomic location of the intussusception related to possible etiology, and hence the most appropriate surgical procedure.
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Affiliation(s)
- Sheng-Mine Wang
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Mbulaiteye SM, Talisuna AO, Ogwang MD, McKenzie FE, Ziegler JL, Parkin DM. African Burkitt's lymphoma: could collaboration with HIV-1 and malaria programmes reduce the high mortality rate? Lancet 2010; 375:1661-3. [PMID: 20452522 DOI: 10.1016/s0140-6736(10)60134-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mbulaiteye SM, Anderson WF, Bhatia K, Rosenberg PS, Linet MS, Devesa SS. Trimodal age-specific incidence patterns for Burkitt lymphoma in the United States, 1973-2005. Int J Cancer 2010; 126:1732-9. [PMID: 19810101 DOI: 10.1002/ijc.24934] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Burkitt lymphoma (BL) is a unique B-cell non-Hodgkin lymphoma with 3 established clinical-epidemiological variants: endemic, sporadic and AIDS-related BL. BL variants show characteristic dysregulation of MYC gene, but the causes of MYC dysregulation or BL arising at different ages are poorly understood. Therefore, we examined population-based BL incidence patterns in the United States to determine age-related risk. BL case and population data were obtained from the NCI's Surveillance, Epidemiology and End Results Databases (1973-2005). Standard cross-sectional age-standardized and age-specific incidence rates were stratified by sex and race and supplemented with age-period-cohort models. We analyzed 3,058 BL cases diagnosed during 1,160,300,297 person-years of observation. Age-standardized incidence rates rose 6.8% per year (95% CI 4.5-9.1) for males and 7.1% (95% CI 3.2-11.1) for females during the study period. The rate among males was 3.2 times that among females, and among Whites 1.3 times that among Blacks. Male-to-female incidence rate ratios did not differ by race, but were 4.2 for pediatric (0-19 years), 4.1 for adult (20-59 years) and 2.0 for geriatric (> or = 60 years) BL. Cross-sectional age-specific rates showed 2 separate peaks among males and females, near ages 10 and 75 years, and a 3rd peak near age 40 years among males. The tri/bimodal incidence pattern was present in sensitivity analyses excluding registries with many HIV/AIDS cases and in period-specific, cohort-specific analyses. To our knowledge, tri/bimodal incidence patterns have not previously been reported for BL. Trimodal/bimodal BL suggests heterogeneity in etiology or biology of BL diagnosed at different ages in males and females.
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Affiliation(s)
- Sam M Mbulaiteye
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute, Bethesda, MD 20852, USA.
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Orbital burkitt lymphoma in immunocompetent patients: a report of 3 cases and a review of the literature. Ophthalmic Plast Reconstr Surg 2010; 25:464-8. [PMID: 19935250 DOI: 10.1097/iop.0b013e3181b80fde] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe a series of 3 immunocompetent patients with the sporadic form of orbital Burkitt lymphoma and review the outcomes of such patients reported in the scientific literature. METHODS Retrospective review of medical records and the literature. Cases of orbital Burkitt lymphoma in immunocompromised and African patients were excluded from the review. Measured parameters included gender, age, ocular signs, imaging results, the range of systemic involvement, and treatment. RESULTS Current cases and review of the scientific literature resulted in 16 immunocompetent patients with sporadic orbital Burkitt lymphoma. The median age at presentation was 12 years. Most common ocular signs at presentation were proptosis (13/16), external ophthalmoplegia (9/16), and eyelid edema (7/16). Optic neuropathy was noted in 5 of 16 patients. Concomitant paranasal sinus involvement was present in 8 of 16 patients. Fourteen (88%) of the patients had systemic involvement, of which the most common locations were central nervous system (6/16), lymphatics (6/16), bone marrow (6/16), and liver (4/16). Survival data were available for 13 patients. Seven patients (54%) died within 12 months of presentation. CONCLUSIONS Sporadic orbital Burkitt lymphoma occurs in immunocompetent individuals with a wide age range. Fifty percent presented with adjacent paranasal sinus involvement. Concurrent or eventual systemic involvement is common. The large number of patients with central nervous system involvement in our review of the literature supports the role of lumbar puncture and neuroimaging in the workup of all patients with orbital Burkitt lymphoma. Prognosis remains guarded, with significant mortality within 1 year of presentation.
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Kiresi D, Karabekmez LG, Koksal Y, Emlik D. A case of Burkitt lymphoma re-presenting as periportal hepatic and multiple organ infiltration. ACTA ACUST UNITED AC 2008; 8:59-61. [PMID: 18501090 DOI: 10.3816/clm.2008.n.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Burkitt lymphoma (BL) is a high-grade, B-cell-originated pediatric malignancy that is a type of non-Hodgkin lymphoma involving different organs. Mediastinal mass, ascites, peritoneal thickening, and infiltration of the small intestine, kidney, and liver were found in our patient. In this case, we describe the radiologic appearances and possible infiltration patterns of multi-organ BL. Also, we discuss infiltration of the periportal area, such as hypodense lesions in the liver, which is rarely seen in BL.
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Affiliation(s)
- Demet Kiresi
- Department of Radiology, Selcuk School of Medicine, Konya, Turkey.
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Nissenbaum M, Kaban LB, Troulis MJ. Toothache, paresthesia, and Horner syndrome: an unusual presentation of disseminated Burkitt's lymphoma. J Oral Maxillofac Surg 2007; 65:1395-401. [PMID: 17577512 DOI: 10.1016/j.joms.2005.08.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Accepted: 08/22/2005] [Indexed: 11/26/2022]
Affiliation(s)
- Mark Nissenbaum
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA 02114, USA
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Okebe JU, Lasserson TJ, Meremikwu MM, Richards S. Therapeutic interventions for Burkitt's lymphoma in children. Cochrane Database Syst Rev 2006:CD005198. [PMID: 17054245 DOI: 10.1002/14651858.cd005198.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Burkitt's lymphoma (BL) is a small non-cleaved cell lymphoma which commonly presents as jaw swellings. Uncertainty remains as to the most effective form of management. OBJECTIVES To assess the evidence of any therapeutic strategy in the treatment of BL. SEARCH STRATEGY We searched MEDLINE (1966-March 2006), LILACS (1982-March 2006), EMBASE (1974-March 2006) and the Cochrane Controlled Trials Register (all years, latest Issue 01/2006) to identify relevant trials. All of these references were accessed in order to identify additional trials in BL. SELECTION CRITERIA Randomised controlled trials (RCTs) of any duration were included. We included studies conducted in children with a confirmed diagnosis of BL. Studies were not restricted by geographical location or by language of publication. Any therapeutic intervention was considered. The primary outcome was overall survival. DATA COLLECTION AND ANALYSIS Two reviewers assessed studies for relevance. Studies that met the entry criteria were assessed for study quality. Data were extracted independently and were entered into RevMan 4.2. MAIN RESULTS Twelve studies met the entry criteria of the review but data could only be retrieved from ten. Inadequate reporting of study methodology was a common feature of the trials preventing thorough assessment of study quality. We were unable to pool data for any of the outcomes due to the differences between the interventions assessed in the studies. Seven studies aimed to induce remission: Overall survival did not differ significantly between treatment groups in three out of four studies reporting this outcome. Five studies aimed to maintain remission: In two out of three studies reporting survival, it was substantially, but not statistically significantly, different between treatment groups. AUTHORS' CONCLUSIONS This review does not currently provide any strong evidence on the relative effectiveness of interventions to treat Burkitt's lymphoma. The studies that have been conducted to date are small, underpowered and prone to both systematic and random error.
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Affiliation(s)
- J U Okebe
- Medical Research Council Laboratories, Malaria Programme, PO Box 273, Fajara, Gambia.
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Palled S, Bedre G, Muckaden MA, Ramadwar M, Bhagwat R, Banavali S, Laskar S. Primary Burkitt's Lymphoma of Frontal Bone: A Rare Presentation. J Clin Oncol 2006; 24:4521-2. [PMID: 16983124 DOI: 10.1200/jco.2006.06.2315] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Siddanna Palled
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India
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Wammanda RD, Ali FU, Adama SJ, Idris HW, Abubakar U. Burkitt's lymphoma presenting as obstructive jaundice. ANNALS OF TROPICAL PAEDIATRICS 2004; 24:103-6. [PMID: 15005975 DOI: 10.1179/027249304225013376] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
A 12-year-old boy presented with a 5-month history of yellowness of the eyes, progressive painless abdominal swelling and weight loss. Physical examination revealed a grossly wasted child with marked jaundice and non-tender hepatomegaly. Liver function tests and abdominal ultrasound suggested obstructive liver disease. Tissue biopsy at laparotomy showed histological findings consistent with Burkitt's lymphoma. He was commenced on cytotoxic chemotherapy and, after two courses, the jaundice disappeared and he remained well. Although ante-mortem presentation of Burkitt's lymphoma as hepatic disease is rare, this condition should be included in the differential diagnosis of a child with obstructive jaundice.
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Affiliation(s)
- R D Wammanda
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
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Jacobs IA, Chang CK, Vizgirda V. Interdisciplinary approach to abdominal Burkitt's lymphoma. ACTA ACUST UNITED AC 2004; 33:133-9. [PMID: 14716062 DOI: 10.1385/ijgc:33:2-3:133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Burkitt's lymphoma is a high-grade, rapidly growing B-cell neoplasm. It is recognized by its aggressive course, brief median survival, and low rates of long-term survival. The authors discuss the case of a patient who acutely presented with intraabdominal complications from a new onset of Burkitt's lymphoma. The clinical and pathological features, staging, treatment options, and survival data are reviewed. In addition, the role of surgical intervention is carefully analyzed.
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Affiliation(s)
- Ira A Jacobs
- Division of Surgical Oncology, Department of Surgery, St. Mary Hospital, Hoboken, NJ, USA.
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Fang SB, Hsiao CH, Tseng CL. Spinal Burkitt's lymphoma manifesting as nocturnal abdominal pain and constipation: a case report. ACTA ACUST UNITED AC 2003; 23:215-9. [PMID: 14567838 DOI: 10.1179/027249303322296547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
A 3-year-old boy presented at the Taiwan Adventist Hospital in Taipei with nocturnal epigastric pain and constipation. Abdominal X-ray showed colonic faecal impaction. Abdominal sonography showed gastric stasis with thickened pyloric wall and dilated rectosigmoid colons. The mouth-to-anus transit time (MATT) was prolonged. Endoscopy showed pale gastric mucosa, atony of pylorus and widening of the duodenal bulb. Three weeks after the onset of abdominal pain, he developed urinary incontinence and rapidly deteriorating paraplegia of lower limbs. Magnetic resonance imaging (MRI) showed an extradural intraspinal mass of T5-T8 and a soft tissue mass in the right superior mediastinum. After a laminectomy and tumour excision, the patient's symptoms improved quickly. The pathology revealed Burkitt's lymphoma. This is the first report of nocturnal abdominal pain and constipation as the initial manifestation of spinal Burkitt's lymphoma.
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Affiliation(s)
- Shiuh-Bin Fang
- Department of Paediatrics, Taiwan Adventist Hospital, Taipei, Taiwan.
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Mora J, Filippa DA, Qin J, Wollner N. Lymphoblastic lymphoma of childhood and the LSA2-L2 protocol: the 30-year experience at Memorial-Sloan-Kettering Cancer Center. Cancer 2003; 98:1283-91. [PMID: 12973853 DOI: 10.1002/cncr.11615] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Until the 1970s, diffuse lymphoblastic lymphoma (DLBL) was considered incurable. With intensive multidrug regimens, the majority of patients can now be cured. In the current study, the authors present what to their knowledge is the longest follow-up presented to date (median, 20 years for survivors) of the largest group of DLBL patients treated with a single protocol at a single institution. METHODS Between 1971-1990, a total of 95 consecutive patients (age < 21 years) with DLBL were treated with the LSA(2)-L(2) protocol at the Memorial Sloan-Kettering Cancer Center (MSKCC). Patients with Stage I-II disease were treated for 2 years. In 1980, the protocol was modified and patients with Stage III and IV disease were treated for 3 years. In addition, before the modification, patients with Stage IV disease received a cumulative dose of 15,600 mg/m(2) of cyclophosphamide for 3 years; after 1980, these patients received the same dosage as the other patients (i.e., 8400 mg/m(2) for 2 years). Radiation therapy initially was administered to all patients with bulky disease in the primary tumor site. Until 1977, the dose of radiation was 20-55 grays (Gy); from 1977 to 1989, the dose was 20 Gy. After the fifth year of completion of treatment, all patients were evaluated comprehensively every 2 years. RESULTS The overall survival (OS) of the patients was 79% with a median follow-up of 20 years. The overall event-free survival (EFS) was 75% (71 of 95 patients). Seventeen patients developed a disease recurrence and 15 died of disease. The OS and EFS rates for patients with Stages I-II disease (n = 8) were 87% and 87%, respectively, and the OS and EFS rates for patients with Stage III disease (n = 41) were 90% and 85%, respectively. The OS and EFS for patients with Stage IVA disease (with bone marrow [BM] involvement of < 25%) (n = 19) were 79% and 73%, respectively, whereas the OS and EFS for patients with Stage IVB disease (BM involvement of > 25%) (n = 27) were 74% and 70%. Of the 29 patients with Stage IV disease who were treated with the original protocol, 7 died of disease (1 of 8 patients with Stage IVA disease and 6 of 21 patients with Stage IVB disease). Of the 17 patients with Stage IV disease who were treated with the modified protocol, 3 died of disease (2 of 11 patients with Stage IVA disease and 1 of 6 patients with Stage IVB disease). Six patients developed secondary malignancies, four of whom died. CONCLUSIONS Long-term EFS can be achieved in the majority of patients with widely disseminated pediatric DLBL. Chemotherapy alone appears to be sufficient prophylaxis against disease recurrence in the central nervous system. No disease-related or treatment-related deaths were reported to occur > 4.5 years after diagnosis in the current study.
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Affiliation(s)
- Jaume Mora
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
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Lehmann LE, Anupindi S, Harris NL. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 18-2003. A 15-year-old girl with pain in the left leg and back, pruritus, and thoracic lymphadenopathy. N Engl J Med 2003; 348:2443-51. [PMID: 12802031 DOI: 10.1056/nejmcpc030007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Oguonu T, Emodi I, Kaine W. Epidemiology of Burkitt's lymphoma in Enugu, Nigeria. ANNALS OF TROPICAL PAEDIATRICS 2002; 22:369-74. [PMID: 12530287 DOI: 10.1179/027249302125002038] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Forty-four children between 3 and 14 years of age with Burkitt's lymphoma were studied at the University of Nigeria Teaching Hospital, Enugu, Nigeria from November 1991 to March 1995. Mean age at presentation was 7.6 years with a male:female ratio of 2.7:1. Eighty-six per cent of the patients lived in a rural area. Of the 23 (52%) from Enugu State, 16 were living in contiguous local government areas with ten clustered round the middle of the year. All the children were of the lowest socio-economic class, 75% of them being in class V. The incidence of Burkitt's lymphoma was higher during the dry season and the period of high malaria transmission (p < 0.05). Abdominal tumour was the commonest mode of presentation (32% of patients). Thirty-six patients were treated with cyclophosphamide, Oncovin, methotrexate and predinisolone (COMP), five received cyclophosphamide alone and three had cyclophosphamide, methotrexate and prednisolone (CMP). Multi-drug regimens achieved better results which were significantly unrelated to the number of cycles of therapy received. Overall, 48% had complete and 35% partial remission, 23% relapsed and 16 (36%) patients died. The epidemiological characteristics of Burkitt's lymphoma in this study were similar to those in other tropical regions.
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Affiliation(s)
- Tagbo Oguonu
- Department of Paediatrics, University of Nigeria Teaching Hospital, PMB 01129, Enugu, Nigeria.
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Carli P, Gisserot O, Landais C, Crémades S, Paris JF, de Jauréguiberry JP. [A patient with febrile and lymphatic hyperalgesia on returning from the tropics]. Rev Med Interne 2002; 23 Suppl 2:253s-255s. [PMID: 12108204 DOI: 10.1016/s0248-8663(02)80012-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- P Carli
- Service de médecine interne, HIA Sainte-Anne, 83800 Toulon Naval, France
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Sandy CJ, Rose GE, Clark BJ, Plowman PN. Sporadic Burkitt's lymphoma presenting as solely orbital disease in a 78-year-old. Eye (Lond) 2001; 15:113-5. [PMID: 11318275 DOI: 10.1038/eye.2001.30] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Yoskovitch A, Hier MP, Bégin LR, Okrainec A, Nachtigal D, Trudel MA, Black MJ. Dorsal tongue mass. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2000; 90:5-8. [PMID: 10884626 DOI: 10.1067/moe.2000.107153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- A Yoskovitch
- Department of Otolaryngology, Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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Dubey SP, Sengupta SK, Kaleh LK, Morewaya JT. Adult head and neck lymphomas in Papua New Guinea: a retrospective study of 70 cases. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1999; 69:778-81. [PMID: 10553965 DOI: 10.1046/j.1440-1622.1999.01694.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND During a 10-year period (1986-95), 70 adult Papua New Guineans with head and neck lymphomas were seen in the 18 years-and-above age group. METHODS The clinical information was obtained from the medical records section of the Port Moresby General Hospital. Relevant treatment modalities and the follow-up data were acquired from the National Cancer Centre, Angau Memorial Hospital, Lae. RESULTS Of a total of 227 adult lymphomas recorded in a 10-year period, 70 cases were seen in the head and neck region. Non-Hodgkin's lymphoma constituted 56 cases, which included seven cases of adult Burkitt's-like lymphoma. Fourteen cases of Hodgkin's lymphoma were recorded. CONCLUSIONS In Papua New Guinea, malignant lymphomas primarily affecting the head and neck region were seen in 30.8% of all lymphomas. This constitues 2.8% of all malignancies in this region. These lymphomas appear to be more aggressive at this site. Proper tissue diagnosis and combination chemoradiotherapy are the key factors in its management.
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Affiliation(s)
- S P Dubey
- Department of Otolaryngology, Port Moresby General Hospital, Papua New Guinea
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Ardekian L, Rachmiel A, Rosen D, Abu-el-Naaj I, Peled M, Laufer D. Burkitt's lymphoma of the oral cavity in Israel. J Craniomaxillofac Surg 1999; 27:294-7. [PMID: 10717831 DOI: 10.1054/jcms.1999.0074] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The clinical presentation of Burkitt's lymphoma in the maxillofacial area is variable. The objective of this study is to review and analyse all cases of Burkitt's lymphoma with oral or maxillofacial involvement diagnosed in our department. A retrospective review of patients with Burkitt's lymphoma in the facial area between the years 1978 and 1997 was undertaken. The patients, 8 male and 5 female, were from 7 to 50 years old (mean 15.3 years). Six patients were Stage I and 7 were Stage II. Five had abdominal involvement and 2 lymph node involvement besides the maxillofacial presentation. Three tumours were in the mandible, 3 in both mandible and maxilla, 2 in the palate, and 5 in the maxilla alone. In 5 patients the tumour presented as a facial swelling, in 3 as an exophytic mass, in 2 as an ulcer, 1 case presented as a hyperplastic lesion, and 2 were periapical lesions. Complaints included pain (7), swelling (5), and sensory disturbance (2). EBV titres were positive in 4 patients. Abdominal involvement was only seen in patients under 12 years old. All patients were treated with chemotherapy, while adjuvant radiotherapy was indicated in 3 cases. Follow-up of 1-20 years revealed a 2-year survival rate of 61.5%. It seems that the Israeli disease is between that of the African and American types, when considering age distribution.
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Affiliation(s)
- L Ardekian
- Department of Oral & Maxillofacial Surgery, Rambam Medical Center, Haifa, Israel.
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Abstract
We describe the radiological findings at presentation and follow up in 24 adult patients with Burkitt's and Burkitt-like lymphoma, age range 17-67 years. This is an older age group than previously described in North American series, but the clinical and imaging characteristics appear similar. Disease confined to the abdomen was seen in 12 (50%) at presentation, of whom 11 had bowel or mesenteric tumours. Of those with bowel involvement, five patients had disease that had arisen in the ileocaecal region. Intra-abdominal disease was large volume (greater than 5 cm) in the majority of patients. Four patients (17%) had small isolated masses in the head and neck region, two (8%) had isolated unilateral axillary lymphadenopathy. Six (25%) patients presented with disseminated disease, all with hepatic and/or splenic involvement, intra-abdominal and peripheral lymphadenopathy. Three of these patients with disseminated disease were human immunodeficiency virus (HIV) positive. Neurological symptoms were present in a total of five patients at presentation or relapse but positive imaging findings were present in only two patients who had MRI. Computed tomography (CT) head scans performed in four patients were normal. Disease recurrence most commonly occurred within the abdomen.
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Affiliation(s)
- K A Johnson
- Department of Radiology, Wessex Oncology Centre, Southampton, UK
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Abstract
Moriz Kaposi was the first who, in 1872, described five patients presenting with "sarcoma idiopathicum multiple hemorrhagicum". In 1912 Sternberg termed this disease Kaposi's sarcoma. Since then various forms of this rare disease have been observed. In 1914 Hallenberg described the first cases of African or endemic Kaposi's sarcoma. In the 1960s the first reports discussing Kaposi's sarcoma following organ transplantation and immunosuppressive therapy were published. After 1981, the epidemic form associated with the acquired immunodeficiency syndrome (AIDS) was described. All these forms, their history, treatment methods and the role of radiation therapy in the management of this rare malignancy are discussed, and the literature is reviewed.
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Affiliation(s)
- Y M Kirova
- Département de cancérologie, Hôpital Henri-Mondor, Créteil, France
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Edelstein C, Shields JA, Shields CL, De Potter P, Eagle RC, Turtel L, Hagstrom N. Non-African Burkitt lymphoma presenting with oral thrush and an orbital mass in a child. Am J Ophthalmol 1997; 124:859-61. [PMID: 9402843 DOI: 10.1016/s0002-9394(14)71714-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To report an unusual case of orbital involvement with non-African Burkitt lymphoma in a child. METHODS A 26-month-old boy developed oral thrush and painless right proptosis with eyelid swelling. Magnetic resonance imaging disclosed a diffuse mass involving the inferior, lateral, and superior right orbit and both maxillary sinuses. Incisional biopsy of the orbital mass was performed. RESULTS Histopathology disclosed diffuse infiltration of the orbital tissues by a high-grade lymphoid neoplasm that showed positive immunoreactivity for B-cell markers. Immunoglobulin gene rearrangement studies disclosed a characteristic t(8;14) translocation consistent with a small, noncleaved malignant lymphoma of the Burkitt type. CONCLUSION Non-African Burkitt lymphoma may manifest with orbital involvement.
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Affiliation(s)
- C Edelstein
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Abstract
Pediatric lymphomas are the third most common group of malignancies in children and adolescents. Unlike lymphomas in adults, pediatric lymphomas are diffuse, aggressive neoplasms with a propensity for widespread dissemination. Intensification of conventional treatment approaches along with improvements in supportive care have resulted in dramatic improvement in event-free survival rates of close to 90% in patients with B-cell lymphomas and only slightly lower in patients with T-cell lymphomas. Lymphoid neoplasms arise because of genetic changes that result in altered growth and differential patterns of lymphoid cells. The characterization of these molecular abnormalities and an understanding of their consequences has led to new approaches to diagnosis and the detection of minimal residual disease and also provides the basis for the future development of novel treatment approaches targeted specifically to the neoplastic cells.
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Affiliation(s)
- A Shad
- Division of Pediatric Hematology Oncology, Vincent T. Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC, USA
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Abstract
Epstein-Barr virus, (EBV) is one of the eight known human herpesviruses and is associated with diseases in a spectrum from benign to lethal. Until recently, there has been no definite treatment for severe EBV infection. However, many therapeutic approaches have been attempted, and some of them seem to be beneficial for a certain EBV-associated disease. This review introduces them and provides a more rational basis for the treatment of severe EBV infection.
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Affiliation(s)
- M Okano
- Department of Pediatrics, Hokkaido University School of Medicine, Sapporo, Japan
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Dechambenoit G, Piquemal M, Giordano C, Cournil C, Ba Zeze V, Santini JJ. Spinal cord compression resulting from Burkitt's lymphoma in children. Childs Nerv Syst 1996; 12:210-4. [PMID: 8739407 DOI: 10.1007/bf00301252] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We report seven cases of spinal cord compression resulting from Burkitt lymphoma in boys aged 15 years and below. This became manifest clinically as acute or rapidly progressive spinal cord compression. All the patients showed total paraplegia with a sensory loss at thoracic level and sphincter disturbances. Four patients were operated on, the operation permitting exeresis of an epidural tumor. In three cases surgery was followed by chemotherapy. One patient was treated exclusively with chemotherapy. Owing to the effectiveness of chemotherapy, surgery should be considered only in cases of rapid deterioration or for diagnostic purposes.
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Affiliation(s)
- G Dechambenoit
- Department of Neurosurgery and Neurology, Centre Hospitalier et Universitaire Abidjan, Cote d'Ivoire
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