Pediatric American Burkitt's lymphoma of the sphenoid sinus

Diffuse large B-cell lymphoma in the sphenoid sinus: A case report and review of literature

Background:

Non-Hodgkin lymphomas (NHLs) in paranasal sinus are uncommon, accounting for 0.17–2% of all NHL cases; it is especially rare in the sphenoid sinus. In this report, we describe a case of NHL in the sphenoid sinus.

Case Description:

A 66-year-old man presented with a sudden left eye movement disorder. His head computed tomography and gadolinium-enhanced magnetic resonance imaging (Gd-MRI) showed a mass lesion extending around the left sphenoid sinus. However, the tumor regrowth about twice was observed during 2 weeks, partial removal of tumor was performed by the endoscopic trans-nasal transsphenoidal surgery, then histologically proved it to be diffuse large B-cell lymphoma (DLBCL). After R-THP-COP regimen (rituximab 375 mg/m²,

cyclophosphamide 750 mg/m², epirubicin 50 mg/m², vincristine 2 mg/day, and prednisolone 100 mg/day) and two courses of intrathecal methotrexate therapy for DLBCL, the symptoms and the lesion of enhanced Gd-MRI and fluorodeoxyglucose-positron emission tomography were completely disappeared.

Conclusion:

NHLs in the sphenoid sinus is very rare disease, however, it is important to be diagnosed pathologically as soon as possible for being in remission state by the chemotherapy.

Widely disseminated sporadic Burkitt lymphoma initially presented as oral manifestations in a 6-year-old boy

Burkitt lymphoma, a subtype of non-Hodgkin's lymphoma, is an aggressive neoplasm with three variants that are endemic, sporadic, and immunodeficiency associated. We present an unusual case of sporadic Burkitt lymphoma in a 6-year-old boy who initially presented with hypermobile teeth and no other specific signs or symptoms. On dental radiography, the patient was found to have alveolar bone resorption adjacent to the maxillary first molars, with the appearance of floating teeth. In addition, magnetic resonance imaging (MRI) showed extensive soft tissue masses involving four quadrants of the jaws. A definitive diagnosis of Burkitt lymphoma was made based on tissue and bone marrow biopsy. Subsequent images, including abdominal computed tomography (CT) and bone scan, revealed wide dissemination of the lymphoma into the abdominal cavity, pancreas, and numerous bones. This case suggests the possibility of dental complaints as an initial clinical manifestation of sporadic Burkitt lymphoma and emphasizes the role of dentists in early detection of the disease to improve prognosis.

Primary Burkitt's Lymphoma in the Nasal Cavity and Paranasal Sinuses

Burkitt's lymphoma is a highly aggressive small B-cell lymphoma. The treatment of choice is complex chemotherapy. As a rare tumor in the head and neck area, Burkitt's lymphoma usually involves cervical lymph nodes, and only fewer than 25% of cases involves extranodal regions. Involvement of the paranasal sinuses has been reported in only 14 cases in the past century. We describe here two patients with rare, sporadic, American type Burkitt's lymphoma involving the nasal cavity and paranasal sinuses manifesting nasal obstruction. We also review clinical and histological features of Burkitt's lymphoma.

Malignant lymphoproliferative disorders extending into the orbit from the paranasal sinuses

BACKGROUND/AIMS

To describe the clinical features, imaging, histologic spectrum, treatment and prognosis of patients with malignant orbital lymphoproliferative disorders extending from the paranasal sinuses.

METHODS

Patients were culled from the University of British Columbia Orbit Clinic (1977-2004) and their clinical charts, imaging and pathology specimens reviewed.

RESULTS

The study included 6 patients with non-Hodgkin's lymphoma (NHL) and 5 multiple myeloma (MM). Orbital symptoms at presentation were periorbital swelling, diplopia, proptosis and pain. Major clinical findings were globe displacement, abnormal ocular movements, periorbital fullness, fifth nerve hypoesthesia and inflammatory signs. Imaging showed a soft tissue mass in one or more sinuses invading the orbit. Three NHL patients were still alive at last follow-up with one patient lost to follow-up. Two NHL patients and all MM died.

CONCLUSION

Presenting symptoms of malignant orbital lymphoproliferative disorders extending from the paranasal sinuses include mass effect occasionally with infiltrative and inflammatory characteristics accompanied by symptoms of sinus disease. On imaging, a soft tissue mass in the sinuses and orbit with bone destruction is commonly seen. Biopsy is essential for conclusive diagnosis. Treatment should be initiated promptly as local symptoms are frequently relieved and survival is possible, especially in cases of NHL.

Burkitt lymphoma involving the clivus

Burkitt lymphoma (BL) is a rapidly dividing tumor that commonly presents itself in the jaw in its endemic form and the abdomen in the sporadic type. Central nervous system involvement at diagnosis is not uncommon, but there have been no previously published reports of BL involving the clivus. Increased tumor burden is associated with complications such as tumor lysis syndrome, and recognition of unusual presentations is important for timely management. We report 3 patients with BL involving the clivus at diagnosis.

Pediatric Burkitt's lymphoma: CT findings

PURPOSE

To review and analyze all CT scans of the cases of Burkitt's lymphoma (BL) in children diagnosed in our institution.

MATERIALS AND METHODS

A retrospective analysis of 33 children with BL between the years 2003 and 2005 seen in our institution was undertaken. Twenty-nine male and four female patients from age 3 to 16 years (with a mean age 5.9 years) were reviewed.

RESULTS

The gastrointestinal tract was involved in 19 patients (57.5%), kidneys in 9 (27.2%), peritoneum in 8 (24.2%), liver in 4 (12.1%), spleen in 3 (9%), adrenals in 3 (9%), and pancreas in 1 patient (3%). Extra-nodal head and neck involvement was seen in eight patients (24.2%). Bone involvement in four (12.1%), lung in three (9%), heart in two (6%), skin in two (6%), and testis in one (3%) of these patients. Abdominal lymph nodes were enlarged in 21 children (63.6%), while cervical lymph nodes were enlarged in 8 (24.2%).

CONCLUSION

CT proved to be an invaluable tool in the characterization of the disease processes in these children. In addition, it provided us with useful information about the anatomical distribution, patterns of involvement, as well as complications of BL.

[Burkitt's nasopharyngeal lymphoma in pediatric age]

The Burkitt's lymphoma is a haematological neoplasia typical of early ages. In our country, the lymphatic nodes affectation is the most usual. We present a case report with a 12 year-old boy who consults for a asymptomatic cervical mass. The ultimate diagnosic was a nasopharyngeal Burkitt's lymphoma with neck extension.

Recurrent syncope as presenting symptom of Burkitt's lymphoma at the carotid bifurcation

Burkitt's lymphoma is rare outside of Africa, and head and neck manifestations of this disease are even more uncommon. We report a case of Burkitt's lymphoma localized at the bifurcation of the right common carotid artery in a 64-year-old man. The presenting symptoms were recurrent syncopes that necessitated a pacemaker, followed by a rapid onset of cranial nerve palsies. The tumor had infiltrated cranial nerves IX, X, XI, and XII and was resected by selective neck dissection. The patient was subsequently treated with a chemotherapeutic regimen consisting of a combination of cytosine arabinoside, vincristine, ifosfamide, prednisone, and an intrathecal application of methotrexate. He also underwent external-beam irradiation of the neck. The patient has been followed up for a period of 42 months and has no evidence of recurrent disease. Repeated diagnostic testing and a coordination of multiple disciplines can speed diagnosis and therapeutic management. The current literature is reviewed and discussed.

Sphenoid sinus involvement in neuroblastoma: a case report and review of the literature

Neuroblastoma is the most common extracranial solid tumors of childhood. The most frequent anatomic site of the primary tumor is abdomen. Metastatic spread of neuroblastoma to lymph node, bone, bone marrow and liver are common at presentation. However, primary or metastatic involvement of sphenoid sinus is extremely rare. Here, we report a case with stage IV neuroblastoma presents with the involvement of the sphenoid sinus. To our knowledge this is the fourth case of neuroblastoma involved sphenoid sinus in English literature.