BURKITT LYMPHOMA IN GASTROINTESTINAL TRACT: A REPORT OF TWO CASES

Burkitt's lymphoma revealed by intestinal obstruction: A case report

Intestinal obstruction is a surgical emergency frequently encountered in routine practice, usually caused by abdominal adhesions. Although extra nodal lymphoma is most often localized in the gastrointestinal tract and may be responsible for intestinal obstruction, Burkitt's lymphoma is a very rare cause in adults. We report a case of Burkitt's lymphoma mimicking an intestinal obstruction in a 48-year-old adult who presented with an obstructive syndrome and altered general condition. Imaging and anatomopathological examination after immunohistochemical analysis concluded to a multi-systemic Burkitt's lymphoma. Chemotherapy was immediately started with complete remission.

High grade Burkitt lymphoma in an immunocompetent young patient: Concomitant gastric and ileal localizations

Burkitt lymphoma is a highly aggressive and rapidly growing B cell non-Hodgkin lymphoma with heterogeneous pattern of manifestations. We present a rare case of a 39-year-old immunocompetent male with double localization of Burkitt lymphoma: gastroduodenal and ileal tract. The gastric location is extremely rare, and the association with another site is unusual with only few reports in the literature. Imaging modalities play a crucial role in correct diagnosis as it can manifest as a focal mass or as segmental wall thickening. Radiologists should recognize common and uncommon presentations and sites of Burkitt lymphoma given the urgency of potential treatment, in order to improve the patient's prognosis.

Burkitt Lymphoma Presenting as Ileocolic Intussusception in an Adult

Adult intussusception is rare, highly associated with a malignant lead point, and often requires emergent surgical management. We report the case of a 44-year-old male who presented with generalized abdominal pain and was found to have early ileocolic intussusception secondary to a large ileocecal mass. Biopsies of the mass and an enlarged cardiophrenic lymph node, as well as pleural fluid cytology were all consistent with Burkitt lymphoma (BL). Curiously, the patient's abdominal exam was reassuring, and the intussusception and malignant bowel obstruction resolved over 36 hours with conservative management alone. With a Burkitt lymphoma international prognostic index (BL-IPI) score of 2, the patient proceeded to treatment with combination chemoimmunotherapy and attained a complete response after four cycles. There was no bowel perforation or recurrent intussusception throughout treatment. Thus, this report marks the first reported case of adult BL-associated intussusception to resolve with non-invasive management and establishes a precedent for conservative management in select patients.

A rare case of Burkitt's lymphoma of the breast in a 19-year-old male: Case report

Key Clinical Message

Burkitt's lymphoma is a highly aggressive non-Hodgkin's lymphoma that can affect various parts of the body, which include jaw, facial bones, retroperitoneum, and abdominal viscera, it is worth noting that breast involvement is extremely rare in Burkitt's lymphoma and has not been documented.

Abstract

Burkitt's lymphoma is a highly aggressive non-Hodgkin's lymphoma that can affect various parts of the body including breast. This sarcoma is identified as a rapidly fatal malignant lymphoma syndrome and 50% of all malignant tumors in children. However, breast involvement has not been documented. A 19-year-old male presented to our emergency department with a left breast swelling for 2 months associated with drenching night sweats, weight loss and evening fevers. Physical examination revealed a mass measuring approximately 15 × 16 × 15 cm in the widest dimension, skin hyperpigmentation, no nipple discolorations, discharges, and non-tender on palpation. Biopsy was done, and the histology report revealed sheets of monomorphic medium lymphocytes with a high mitotic rate and frequent apoptotic bodies showing a starry-sky appearance. The immunohistochemistry report revealed positive staining for Ki-67, CD-20, and CD-10 tumor markers and CD45 on flow cytometry. The patient was started on aggressive hydration, rasubricase administration, CODOX-M/IVAC regimen 6 cycles, and G-CSF and registered significant reduction in the size of the mass. Burkitt's lymphoma is a highly aggressive non-Hodgkin's lymphoma that can affect various parts of the body. It commonly involves the jaw, facial bones, retroperitoneum, and abdominal viscera. The disease typically affects young patients in areas of high incidence, such as the jaw, whereas visceral involvement is more common in older patients in low-incidence areas. It is worth noting that breast involvement is extremely rare in Burkitt's lymphoma.

Gallbladder Burkitt’s lymphoma mimicking gallbladder cancer: A case report

BACKGROUND

Malignant lymphoma is a rare form of gallbladder malignancy. Most of these malignancies are diffuse large B-cell lymphomas or mucosa-associated lymphoid tissue-type lymphomas; however, Burkitt’s lymphoma of the gallbladder is extremely rare, and only two previous reports are available in the literature. Herein, we report a rare case of Burkitt’s lymphoma of the gallbladder mimicking gallbladder adenocarcinoma.

CASE SUMMARY

An 83-year-old man with no abdominal complaints was found to have a gallbladder tumor and periportal lymph node enlargement on computed tomography (CT) performed for hypertension screening. His laboratory data revealed slightly elevated serum levels of carcinoembryonic antigen and soluble interleukin 2 receptor. Imaging examinations revealed two irregular and contrast-enhanced masses extending into the gallbladder lumen, but these did not infiltrate the serosa. Moreover, a periportal lymph node had enlarged to 30 mm. Based on these findings, we diagnosed the patient as having gallbladder adenocarcinoma with lymph node metastasis, which was treated using bile duct resection with gallbladder bed resection and periportal lymph node dissection. However, the patient was finally diagnosed as having Burkitt’s lymphoma. Although the surgical margin was pathologically negative, recurrence was noted at the hepatic radical margin and superior pancreaticoduodenal lymph nodes on positron emission tomography/CT soon after discharge. Thus, he was referred to a hematologist and started receiving treatment with reduced-dose cyclophosphamide, doxorubicin, vincristine, and prednisone.

CONCLUSION

Burkitt’s lymphoma can occur in the gallbladder. Biopsy can be useful in cases with findings suggestive of gallbladder malignant lymphoma.

An unusual cause of large bowel obstruction: are we aware of this?

Primary lymphomas of the colon account for 0.5% of all primary colon malignancies. Burkitt´s lymphoma is a B-cell lymphoma with aggressive clinical behavior. Herein, we describe a case of a male patient who presented with signs of large bowel obstruction, underwent surgery and found to suffer from Burkitt´s lymphoma of the ileocecal region. The histopathological examination was indicative for Burkitt´s lymphoma. To the best of our insight this is one of the few reported cases of such type of lymphoma in an adult patient presenting with bowel obstruction. Burkitt´s lymphoma is a rare malignancy in adults affecting gastrointestinal tract. It has a high proliferation potential and can rapidly progress to advanced disease. Early diagnosis is necessary to prevent complications and improve overall prognosis.