1
|
Silva Filho NJD, Cardoso DDM, Kayahara GM, Xavier-Júnior JCC, Cortopassi GM, Fonseca FP, Miyahara GI, Bernabé DG, Valente VB. Primary manifestation of HIV-related Burkitt lymphoma in the oral and maxillofacial regions. J Am Dent Assoc 2024; 155:344-348. [PMID: 38244019 DOI: 10.1016/j.adaj.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Burkitt lymphoma (BL) is a subtype of non-Hodgkin lymphoma. It is strongly associated with HIV infection and has a highly aggressive clinical course. The involvement of the maxillofacial region in BL has rarely been reported. CASE DESCRIPTION A 36-year-old woman with HIV-positive status had painless bilateral swelling of the oral mucosa and middle and lower thirds of the face. Microscopic analysis of the oral lesion revealed an atypical lymphoid infiltrate with a starry sky pattern. The lymphoid cells expressed cluster of differentiation 20, cluster of differentiation 10, B-cell lymphoma 6, and c-Myc; the Ki-67 proliferative index was high. The tumor cells were positive for Epstein-Barr virus. These results led to the diagnosis of HIV-related BL. PRACTICAL IMPLICATIONS BL and other immunodeficiency-related lymphoproliferative malignancies may affect the oral and maxillofacial regions and should be included in the differential diagnosis of rapidly expanding swelling in young patients.
Collapse
|
2
|
Pan S, Shen Q, Zhou J, Li T. Spontaneous tumor lysis syndrome (STLS) during biopsy for burkitt lymphoma: a case report. BMC Pediatr 2024; 24:209. [PMID: 38521927 PMCID: PMC10960423 DOI: 10.1186/s12887-024-04679-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 03/01/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Tumor lysis syndrome (TLS) is a hematologic oncological emergency characterized by metabolic and electrolyte imbalances. On breakdown of tumor cells, enormous amounts of potassium, phosphate, and nucleic acids are released into systemic circulation. TLS mainly occurs during chemotherapy. However, there are rare incidences of spontaneous tumor lysis syndrome (STLS) prior to commencement of therapy. CASE PRESENTATION In the case being reported, the child had just undergone a biopsy. As the incision was being closed, there was a sudden onset of high fever, arrhythmia, severe hyperkalemia, hypocalcemia, and acidosis. Following timely symptomatic treatment and continuous renal replacement therapy(CRRT), the child's laboratory results improved, and organ function was restored to normal. The final pathological diagnosis confirmed Burkitt lymphoma. The boy is currently on maintenance chemotherapy. CONCLUSIONS TLS is a potentially life-threatening complication in hematologic oncology. Several important conclusions can be drawn from this case, reminding clinicians to: (1) be fully aware of the risk factors of TLS and evaluate the level of risk; (2) pay attention to the possibility of STLS during operation, if surgical procedures are necessary and operate with minimal trauma and in the shortest time possibly; (3) take preoperative prophylaxis actively for high-risk TLS patients, including aggressive fluid management and rational use of diuretics and uric-acid-lowering drugs. In addition, this case confirms the effectiveness of CRRT for severe STLS.
Collapse
Affiliation(s)
- Sirui Pan
- Department of Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Qiyang Shen
- Department of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jianfeng Zhou
- Department of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Tao Li
- Department of Oncology, Children's Hospital of Nanjing Medical University, Nanjing, China.
| |
Collapse
|
3
|
Tereshko Y, Hector Ercole B, Christian L, Belgrado E, Dal Bello S, Giovanni M, Luigi Gigli G, Valente M. Botulinum toxin type A improves pain in numb chin syndrome. Toxicon 2024; 238:107565. [PMID: 38159684 DOI: 10.1016/j.toxicon.2023.107565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Abstract
Numb chin syndrome is a rare pain disorder characterized by decreased sensation and paresthesia in the territory of the mental nerve. Neuropathic pain is sometimes described in this setting, and the most common treatments include oral analgesics, gabapentinoids, and carbamazepine; however, botulinum toxin type A has never been used in this setting. We describe a case of bilateral numb chin syndrome, secondary to Burkitt lymphoma, associated with refractory and persistent burning neuropathic pain, effectively treated twelve times with subcutaneous Botulinum toxin type A (BoNT/A) injections. The procedure was well tolerated, but the patient reported incomplete mouth closure of minimal entity. BoNT/A could be a safe and effective therapy for neuropathic pain associated with numb chin syndrome.
Collapse
Affiliation(s)
- Yan Tereshko
- Clinical Neurology Unit, Department of Head-neck and Neurosciences, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100, Udine, Italy.
| | - Bruno Hector Ercole
- Clinical Neurology Unit, Department of Head-neck and Neurosciences, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100, Udine, Italy
| | - Lettieri Christian
- Neurology Unit, Department of Head-neck and Neurosciences, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100, Udine, Italy; Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Enrico Belgrado
- Neurology Unit, Department of Head-neck and Neurosciences, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100, Udine, Italy; Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Simone Dal Bello
- Clinical Neurology Unit, Department of Head-neck and Neurosciences, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100, Udine, Italy
| | - Merlino Giovanni
- Clinical Neurology Unit, Department of Head-neck and Neurosciences, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100, Udine, Italy
| | - Gian Luigi Gigli
- Neurology Unit, Department of Head-neck and Neurosciences, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100, Udine, Italy; Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology Unit, Department of Head-neck and Neurosciences, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100, Udine, Italy; Neurology Unit, Department of Head-neck and Neurosciences, Udine University Hospital, Piazzale Santa Maria Della Misericordia 15, 33100, Udine, Italy; Department of Medicine (DAME), University of Udine, Udine, Italy
| |
Collapse
|
4
|
Butterworth JW, Brooker-Thompson C, Qureshi YA, Mohammadi B, Dawas K. Emergency laparotomy for abdominal catastrophes secondary to lymphoma: A systematic review. Eur J Surg Oncol 2024; 50:107268. [PMID: 38043361 DOI: 10.1016/j.ejso.2023.107268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/25/2023] [Accepted: 11/10/2023] [Indexed: 12/05/2023]
Abstract
Intestinal lymphomas can rarely present as abdominal catastrophes with perforation or small bowel obstruction. There is little data regarding their optimal surgical management and associated outcomes. We aimed to systematically review relevant published literature to assess the presentation, diagnosis, optimal surgical approach and associated post-operative outcomes. A systematic on-line literature search of Embase and Medline identified 1485 articles of which 34 relevant studies were selected, including 7 retrospective studies, 1 case series and 26 case reports. Selected articles were assessed by two reviewers to extract data. 95 patients with abdominal catastrophes secondary to lymphoma (predominately Burkitt (28 %) and Diffuse Large B-cell lymphoma (29 %)) were identified with a median age of 52 years, 40 % were female. Of the small bowel resections 25% (n = 18) suffered post-operative complications with a 13.8 % (n = 10) 30-day mortality. Ileocolonic resections had a 27 % complication rate with 18 % mortality and primary repair had a 25 % complications rate and 25 % mortality. Median follow-up was 8 days (range 1-96). Notable points of differences in the presentations between these different lymphomas included the majority of Burkitt's lymphoma were younger, had a known diagnosis, were on chemotherapy and presented with perforation in contrast to those with B cell lymphoma who were predominately older, had new diagnoses and presented with a balanced proportion of obstruction and perforation. Abdominal catastrophes secondary to intestinal lymphomas most commonly present with perforation. Aggressive surgical management, including small bowel resection, may offer similar remission rates for lymphoma patients presenting with abdominal catastrophes as those without such emergency complications.
Collapse
Affiliation(s)
| | | | | | | | - Khaled Dawas
- Department of Upper GI Surgery, University College Hospital London, UK
| |
Collapse
|
5
|
Tuin AM, Wieland CM, Dort EJ, Dilsaver DB, Velagapudi M. Readmission rates in HIV-associated burkitt lymphoma patients in the USA: a nationwide readmission database (NRD) analysis. AIDS Res Ther 2023; 20:79. [PMID: 37951907 PMCID: PMC10638679 DOI: 10.1186/s12981-023-00575-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND People with human immunodeficiency virus have an increased risk of developing AIDS-defining malignancies including Burkitt lymphoma. Survival outcomes in HIV-associated Burkitt lymphoma remain worse than non-HIV-associated Burkitt lymphoma, despite widespread implementation of antiretroviral therapy. We aimed to determine the association between HIV status and risk for 30-day and 90-day readmission in the US after index hospitalization for Burkitt lymphoma. METHODS Data were abstracted from the 2010-2020 Nationwide Readmissions Database; hospitalizations included patients with a primary BL diagnosis and were stratified by comorbid HIV. The primary outcome was all-cause readmission (30-day and 90-day). Secondary outcomes were in-hospital mortality, length of stay (LOS), and hospital cost. Between-HIV differences were evaluated via logistic and log-normal regression; multivariable models adjusted for comorbid kidney disease, hypertension, fluid and electrolyte disorders, and sepsis. RESULTS Overall, there were 8,453 hospitalizations for BL and 6.0% carried an HIV diagnosis. Of BL hospitalizations, 68.4% were readmitted within 30-days post index BL hospitalization and 6.8% carried a HIV diagnosis. HIV-associated BL was associated with 43% higher adjusted odds of 30-day readmission (aOR 95% CI: 4% higher to 97% higher, p = 0.026). For 90-day readmission, 76.0% of BL patients were readmitted and 7.0% carried a HIV diagnosis. HIV-associated BL was not statistically associated with all-cause 90-day readmission (aOR 1.46, aOR 95% CI: 0% higher to 115% higher, p = 0.053). CONCLUSIONS HIV-positive status is associated with an increased risk for 30-day readmission after index hospitalization for Burkitt lymphoma.
Collapse
Affiliation(s)
- Ashley M Tuin
- Creighton University School of Medicine, CHI Health, Omaha, NE, USA
| | - Clare M Wieland
- Creighton University School of Medicine, CHI Health, Omaha, NE, USA
| | - Elizabeth J Dort
- Creighton University School of Medicine, CHI Health, Omaha, NE, USA
| | - Danielle B Dilsaver
- Department of Clinical Research & Public Health, Creighton University School of Medicine, Omaha, NE, USA
| | - Manasa Velagapudi
- Creighton University School of Medicine, CHI Health, Omaha, NE, USA.
- Division of Infectious Diseases, Department of Internal Medicine, Creighton University School of Medicine, Omaha, NE, 68154, USA.
| |
Collapse
|
6
|
Kenkel TJ, Sridhar N, Hammons LR, Hintzke M, Shah NN. Bone Marrow Aplasia after CAR-T-Cell Therapy for Relapsed/Refractory Burkitt's Lymphoma. Med Sci (Basel) 2023; 11:67. [PMID: 37873752 PMCID: PMC10594436 DOI: 10.3390/medsci11040067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/07/2023] [Accepted: 10/08/2023] [Indexed: 10/25/2023] Open
Abstract
Chimeric antigen receptor T-cells (CAR-T) are now a standard approach for treating relapsed/refractory B-cell lymphomas. Immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome (IEC-HS) is a newly described entity that can manifest following CAR-T. Bone marrow (BM) aplasia is an uncommon manifestation of IEC-HS reported after CAR-T-cell therapy and is defined as the reduction or absence of hematopoietic progenitor cells resulting in severe pancytopenia. We describe the case of a 44-year-old female with relapsed/refractory Burkitt lymphoma (BL) who received treatment with lisocabtagene maraleucel with her post-CAR-T course complicated by cytokine release syndrome (CRS) and IEC-HS ultimately leading to persistent BM aplasia. She underwent a rescue allogeneic stem cell transplant but ultimately succumbed to progressive disease. IEC-HS is an increasingly recognized complication that occurs after CAR-T treatments that can result in aplasia, a dangerous complication with serious sequelae including infection, transfusion dependence, and high risk for hemorrhage. The underlying mechanism is poorly understood, and further studies are needed to understand how to treat it better.
Collapse
Affiliation(s)
- Troy J. Kenkel
- Department of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Nithya Sridhar
- Department of Internal Medicine, Baylor College of Medicine, Houston, TX 77030, USA;
| | - Lindsay R. Hammons
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Maria Hintzke
- Department of Pathology & Laboratory Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Nirav N. Shah
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| |
Collapse
|
7
|
Deng KH, Wei DH, Liu W. Ileo-Ileal Intussusception by Burkitt's Lymphoma. J Gastrointest Surg 2023; 27:2266-2267. [PMID: 37369965 DOI: 10.1007/s11605-023-05768-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023]
Affiliation(s)
- Ke-Heng Deng
- Department of Pediatric Surgery, Yichang Central People's Hospital, Yichang, China
| | - Dao-Hui Wei
- Institute of Digestive Disease, China Three Gorges University, 8 Daxue Road, Yichang, 443000, China
- Department of Gastroenterology, Yichang Central People's Hospital, Yichang, China
| | - Wei Liu
- Institute of Digestive Disease, China Three Gorges University, 8 Daxue Road, Yichang, 443000, China.
- Department of Gastroenterology, Yichang Central People's Hospital, Yichang, China.
| |
Collapse
|
8
|
Masmoudi M, Hasnaoui M, Ben Abdeljalil N, Belaid T, Regaieg M, Chebil E, Mighri K. Burkitt's Thyroid Lymphoma Revealed in a Pregnant Woman With Acute Dyspnea. Ear Nose Throat J 2023; 102:NP485-NP488. [PMID: 34107797 DOI: 10.1177/01455613211024877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Extraganglionic Burkitt's lymphoma is rare. Primary thyroid localization accounts for 1% to 5% of malignant tumors of the thyroid gland. The association of Burkitt's lymphoma and pregnancy is even rarer. Our patient was pregnant at 36 weeks. She was brought to the emergency department with anterior cervical swelling, rapidly increasing in volume and becoming compressive for 15 days, in addition to dysphonia and inspiratory dyspnea. Cervical ultrasound and computed tomography scan revealed a compressive and plunging goiter. Surgery attempted after fetal extraction proved impossible due to massive tumor infiltration into adjacent structures shielding the cervical region. Accordingly, the act was limited to a glandular biopsy. The newborn was healthy. Histological examination confirmed the diagnosis of Burkitt's lymphoma. Given the poor general condition of the patient, chemotherapy was not administered and the patient died after 15 days of stay in intensive care unit.
Collapse
Affiliation(s)
- Mohamed Masmoudi
- Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
| | - Mehdi Hasnaoui
- Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
| | - Nouha Ben Abdeljalil
- Cytopathology Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Takwa Belaid
- Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
| | - Marwa Regaieg
- Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
| | - Ezer Chebil
- Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
| | - Khalifa Mighri
- Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, Tunisia
| |
Collapse
|
9
|
Díaz García A, García Niebla J, Reyes Correa B, Pérez Álvarez AD, Barrera Gómez MÁ. Burkitt's lymphoma in the adult as an unusual cause of large bowel obstruction. Rev Esp Enferm Dig 2023; 115:466-467. [PMID: 36426851 DOI: 10.17235/reed.2022.9306/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Bowel obstruction is an uncommon clinical presentation in Burkitt´s lymphoma, specially in adults. This type of lymphoma is classified within B-cell non-Hodgkin´s lymphomas, which is characterized by its aggressiveness and quickly tumoral growth. The clinical presentation related to the gastrointestinal tract is unusual, but it can be presented as intussusception, obstruction or ischemic perforation. Here we describe a case of Burkitt´s lymphoma with bowel obstruction as a clinical debut.
Collapse
Affiliation(s)
- Alberto Díaz García
- Cirugía General y Digestiva, Hospital Universitario Nuestra Sra. de Candelaria, España
| | | | | | | | | |
Collapse
|
10
|
McNerney KO, Si Lim SJ, Ishikawa K, Dreyzin A, Vatsayan A, Chen JJ, Baggott C, Prabhu S, Pacenta HL, Philips C, Rossoff J, Stefanski HE, Talano JA, Moskop A, Verneris M, Myers D, Karras NA, Brown P, Bonifant CL, Qayed M, Hermiston M, Satwani P, Krupski C, Keating AK, Baumeister SHC, Fabrizio VA, Chinnabhandar V, Egeler E, Mavroukakis S, Curran KJ, Mackall CL, Laetsch TW, Schultz LM. HLH-like toxicities predict poor survival after the use of tisagenlecleucel in children and young adults with B-ALL. Blood Adv 2023; 7:2758-2771. [PMID: 36857419 PMCID: PMC10275701 DOI: 10.1182/bloodadvances.2022008893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 03/03/2023] Open
Abstract
Chimeric antigen receptor-associated hemophagocytic lymphohistiocytosis (HLH)-like toxicities (LTs) involving hyperferritinemia, multiorgan dysfunction, coagulopathy, and/or hemophagocytosis are described as occurring in a subset of patients with cytokine release syndrome (CRS). Case series report poor outcomes for those with B-cell acute lymphoblastic leukemia (B-ALL) who develop HLH-LTs, although larger outcomes analyses of children and young adults (CAYAs) with B-ALL who develop these toxicities after the administration of commercially available tisagenlecleucel are not described. Using a multi-institutional database of 185 CAYAs with B-ALL, we conducted a retrospective cohort study including groups that developed HLH-LTs, high-grade (HG) CRS without HLH-LTs, or no to low-grade (NLG) CRS without HLH-LTs. Primary objectives included characterizing the incidence, outcomes, and preinfusion factors associated with HLH-LTs. Among 185 CAYAs infused with tisagenlecleucel, 26 (14.1%) met the criteria for HLH-LTs. One-year overall survival and relapse-free survival were 25.7% and 4.7%, respectively, in those with HLH-LTs compared with 80.1% and 57.6%, respectively, in those without. In multivariable analysis for death, meeting criteria for HLH-LTs carried a hazard ratio of 4.61 (95% confidence interval, 2.41-8.83), controlling for disease burden, age, and sex. Patients who developed HLH-LTs had higher pretisagenlecleucel disease burden, ferritin, and C-reactive protein levels and lower platelet and absolute neutrophil counts than patients with HG- or NLG-CRS without HLH-LTs. Overall, CAYAs with B-ALL who developed HLH-LTs after tisagenlecleucel experienced high rates of relapse and nonrelapse mortality, indicating the urgent need for further investigations into prevention and optimal management of patients who develop HLH-LTs after tisagenlecleucel.
Collapse
Affiliation(s)
- Kevin O. McNerney
- Cancer and Blood Disorders Institute, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Stephanie J. Si Lim
- Division of Oncology, Department of Pediatrics, John A. Burns School of Medicine, University of Hawai’i at Manoa, Honolulu, HI
| | - Kyle Ishikawa
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai’i at Manoa, Honolulu, HI
| | - Alexandra Dreyzin
- Center for Cancer and Blood Disorders, Children’s National Hospital, Washington, DC
| | - Anant Vatsayan
- Center for Cancer and Blood Disorders, Children’s National Hospital, Washington, DC
| | - John J. Chen
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai’i at Manoa, Honolulu, HI
| | - Christina Baggott
- Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA
| | - Snehit Prabhu
- Center for Cancer Cell Therapy, Stanford Cancer Institute, School of Medicine, Stanford University, Stanford, CA
| | - Holly L. Pacenta
- Department of Pediatrics, University of Texas Southwestern Medical Center/Children’s Health, Dallas, TX
- Division of Hematology and Oncology, Cook Children’s Medical Center, Fort Worth, TX
| | - Christine Philips
- Division of Pediatrics, University of Cincinnati, Cincinnati, OH
- Cincinnati Children’s Hospital Medical Center, Cancer and Blood Disease Institute, Cincinnati, OH
| | - Jenna Rossoff
- Division of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
| | | | - Julie-An Talano
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Department of Pediatrics, Medical College of Wisconsin and Children’s Wisconsin, Milwaukee, WI
| | - Amy Moskop
- Division of Hematology/Oncology/Blood and Marrow Transplantation, Department of Pediatrics, Medical College of Wisconsin and Children’s Wisconsin, Milwaukee, WI
| | - Michael Verneris
- University of Colorado School of Medicine, Children’s Hospital of Colorado, Aurora, CO
| | - Doug Myers
- Department of Hematology, Oncology and Blood and Marrow Transplantation, Children’s Mercy Hospital, University of Missouri Kansas City, Kansas City, MO
| | - Nicole A. Karras
- Department of Pediatrics, City of Hope National Medical Center, Duarte, CA
| | - Patrick Brown
- Department of Oncology, Sidney Kimmel Cancer Center, John Hopkins University School of Medicine, Baltimore, MD
| | - Challice L. Bonifant
- Department of Oncology, Sidney Kimmel Cancer Center, John Hopkins University School of Medicine, Baltimore, MD
| | - Muna Qayed
- Division of Pediatric Hematology/Oncology and Bone Marrow Transplantation, Aflac Cancer and Blood Disorders Center, Emory University and Children’s Healthcare of Atlanta, Atlanta, GA
| | - Michelle Hermiston
- University of California San Francisco Benioff Children's Hospital, San Francisco, CA
| | - Prakash Satwani
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Columbia University Medical Center, New York, NY
| | - Christa Krupski
- Division of Pediatrics, University of Cincinnati, Cincinnati, OH
- Cincinnati Children’s Hospital Medical Center, Cancer and Blood Disease Institute, Cincinnati, OH
| | - Amy K. Keating
- University of Colorado School of Medicine, Children’s Hospital of Colorado, Aurora, CO
| | - Susanne H. C. Baumeister
- Division of Pediatric Hematology-Oncology, Boston Children’s Hospital, Boston, MA
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Vanessa A. Fabrizio
- University of Colorado School of Medicine, Children’s Hospital of Colorado, Aurora, CO
| | - Vasant Chinnabhandar
- Division of Pediatric Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Emily Egeler
- Center for Cancer Cell Therapy, Stanford Cancer Institute, School of Medicine, Stanford University, Stanford, CA
| | - Sharon Mavroukakis
- Center for Cancer Cell Therapy, Stanford Cancer Institute, School of Medicine, Stanford University, Stanford, CA
| | - Kevin J. Curran
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Pediatrics, Weill Cornell Medical College, Cornell University, New York, NY
| | - Crystal L. Mackall
- Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA
- Center for Cancer Cell Therapy, Stanford Cancer Institute, School of Medicine, Stanford University, Stanford, CA
- Department of Medicine, School of Medicine, Stanford University, Stanford, CA
| | - Theodore W. Laetsch
- Department of Pediatrics and Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Division of Oncology, Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Liora M. Schultz
- Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA
| |
Collapse
|
11
|
Hu JN, Yu MQ, Hua LJ, Bao C, Liu Q, Liu C, Li ZL, Wang X, Xu SY. Tuberculosis combined with Burkitt lymphoma in a kidney transplant recipient: A case report and literature review. Medicine (Baltimore) 2023; 102:e33671. [PMID: 37144990 PMCID: PMC10158922 DOI: 10.1097/md.0000000000033671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/12/2023] [Indexed: 05/06/2023] Open
Abstract
RATIONALE Tuberculosis (TB) and post-transplant lymphoproliferative disorder are serious complications affecting the long-term survival of kidney transplant recipients (KTRs). Both of complications have overlapping clinical symptoms, signs, and high similar imaging presentation, which make early clinical diagnosis challenging. In this paper, we reported a rare case of post-transplant pulmonary TB combined with Burkitt lymphoma (BL) in KTR. PATIENT CONCERNS A 20-year-old female KTR presented to our hospital with abdominal pain and multiple nodules throughout the body. DIAGNOSES TB is diagnosed based on the lung histopathology showed fibrous connective tissue hyperplasia with number of chronic inflammatory changes, localized necrosis, granuloma formation and multinucleated giant cells were seen in the lung tissue. Moreover, lung histopathology specimen tested positive for TB gene. TB The culture for tuberculosis was positive. BL was diagnosed as metastatic after completion of liver and bone marrow biopsy. INTERVENTIONS After an early diagnosis of TB, the patient received intensification of anti-tubercular therapy. Because the patient was diagnosed with BL, rituximab, cardioprotection, hepatoprotection and alkalinization of urine were added. OUTCOMES After an early diagnosis of TB, the patient received anti-tubercular therapy and her clinical symptoms and imaging manifestations improved. After the diagnosis of BL was made, the patient's condition progressed rapidly, followed by multi-organ damage and died 3 months later. LESSONS Therefore, in organ transplant patients, who present with multiple nodules and normal tumor markers, they should be alerted to the possibility of concurrent TB and post-transplant lymphoproliferative disorder, and perfect tests such as Epstein-Barr virus, β2-microglobulin, lactate dehydrogenase, γ-interferon release test and Xpert Mycobacterium TB/rifampicin test and perform early lesion site biopsy to clarify the diagnosis with a view to improving the prognosis.
Collapse
Affiliation(s)
- Jian-Nan Hu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Mu-Qing Yu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Li-Juan Hua
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Chen Bao
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Qian Liu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Chao Liu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Zi-Ling Li
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Xi Wang
- Institute of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Key Laboratory of Pulmonary Disease of Ministry of Health of China, Wuhan, PR China
| | - Shu-Yun Xu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| |
Collapse
|
12
|
Gondwe Y, Salima A, Manda A, Ozuah N, Mapurisa G, Brandt K, Gopal S, Tomoka T, Fedoriw Y, Westmoreland KD. Spatial distribution of incident pediatric Burkitt lymphoma in central and northern Malawi and association with malaria prevalence. Pediatr Blood Cancer 2022; 69:e29867. [PMID: 35731580 PMCID: PMC10846644 DOI: 10.1002/pbc.29867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/27/2022] [Accepted: 06/09/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Burkitt lymphoma (BL) accounts for 90% of pediatric lymphomas in sub-Saharan Africa. Plasmodium falciparum malaria is considered an etiological factor of BL. We describe the geographic distribution of pediatric BL in Malawi and association with P. falciparum malaria prevalence rate (PfPR). METHODS We enrolled 220 pathologically confirmed incident pediatric BL cases (2013-2018) into an observational clinical cohort at Kamuzu Central Hospital (KCH) in Lilongwe district. KCH is the main tertiary cancer referral center serving the central and northern regions of Malawi. Using an ecological study design, we calculated district-level annual BL incidence rate using census population estimates. District-level PfPR was extracted from the National Malaria Control Program 2010 report. BL incidence and PfPR maps were constructed in QGIS. Moran's I test was used to identify BL spatial clusters. Pearson's correlation and multiple linear regression analyses were used to statistically examine the relationship between PfPR and BL. RESULTS BL incidence was higher in central region districts (8.2 cases per million) than northern districts (2.9 cases per million) and was elevated in lakeshore districts. Districts with elevated PfPR tended to have elevated BL incidence. A low-risk BL cluster was detected in the north. Statistically, BL incidence was positively correlated with PfPR (r = .77, p < .01). A 1% increase in PfPR predicted an increase in BL incidence of 0.2 cases per million (p = .03), when controlling for travel time from referral district hospital to KCH. CONCLUSION Our study supports evidence for an association between P. falciparum and BL and highlights a need to improve geographic accessibility to tertiary cancer services in Malawi's northern region.
Collapse
Affiliation(s)
- Yolanda Gondwe
- University of North Carolina Project-Malawi, University of North Carolina, Lilongwe, Malawi
| | - Ande Salima
- University of North Carolina Project-Malawi, University of North Carolina, Lilongwe, Malawi
| | - Agness Manda
- University of North Carolina Project-Malawi, University of North Carolina, Lilongwe, Malawi
| | | | - Gugulethu Mapurisa
- University of North Carolina Project-Malawi, University of North Carolina, Lilongwe, Malawi
| | - Katerina Brandt
- Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Satish Gopal
- National Cancer Institute Center for Global Health, Bethesda, Maryland, USA
| | - Tamiwe Tomoka
- University of North Carolina Project-Malawi, University of North Carolina, Lilongwe, Malawi
| | - Yuri Fedoriw
- University of North Carolina Project-Malawi, University of North Carolina, Lilongwe, Malawi
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Katherine D Westmoreland
- University of North Carolina Project-Malawi, University of North Carolina, Lilongwe, Malawi
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| |
Collapse
|
13
|
Dias MHF, Guimarães LFF, Barcelos MG, Moreira EUM, do Nascimento MFA, de Souza TN, Pires CV, Monteiro TAF, Middeldorp JM, Soares IS, Fontes CJF, Ntumngia FB, Adams JH, Kano FS, Carvalho LH. Impact of Epstein-Barr virus co-infection on natural acquired Plasmodium vivax antibody response. PLoS Negl Trop Dis 2022; 16:e0010305. [PMID: 35921373 PMCID: PMC9377613 DOI: 10.1371/journal.pntd.0010305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/15/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022] Open
Abstract
Background
The simultaneous infection of Plasmodium falciparum and Epstein-Barr virus (EBV) could promote the development of the aggressive endemic Burkitt’s Lymphoma (eBL) in children living in P. falciparum holoendemic areas. While it is well-established that eBL is not related to other human malaria parasites, the impact of EBV infection on the generation of human malaria immunity remains largely unexplored. Considering that this highly prevalent herpesvirus establishes a lifelong persistent infection on B-cells with possible influence on malaria immunity, we hypothesized that EBV co-infection could have impact on the naturally acquired antibody responses to P. vivax, the most widespread human malaria parasite.
Methodology/Principal findings
The study design involved three cross-sectional surveys at six-month intervals (baseline, 6 and 12 months) among long-term P. vivax exposed individuals living in the Amazon rainforest. The approach focused on a group of malaria-exposed individuals whose EBV-DNA (amplification of balf-5 gene) was persistently detected in the peripheral blood (PersVDNA, n = 27), and an age-matched malaria-exposed group whose EBV-DNA could never be detected during the follow-up (NegVDNA, n = 29). During the follow-up period, the serological detection of EBV antibodies to lytic/ latent viral antigens showed that IgG antibodies to viral capsid antigen (VCA-p18) were significantly different between groups (PersVDNA > NegVDNA). A panel of blood-stage P. vivax antigens covering a wide range of immunogenicity confirmed that in general PersVDNA group showed low levels of antibodies as compared with NegVDNA. Interestingly, more significant differences were observed to a novel DBPII immunogen, named DEKnull-2, which has been associated with long-term neutralizing antibody response. Differences between groups were less pronounced with blood-stage antigens (such as MSP1-19) whose levels can fluctuate according to malaria transmission.
Conclusions/Significance
In a proof-of-concept study we provide evidence that a persistent detection of EBV-DNA in peripheral blood of adults in a P. vivax semi-immune population may impact the long-term immune response to major malaria vaccine candidates.
Collapse
Affiliation(s)
| | | | | | | | | | - Taís N. de Souza
- Instituto René Rachou/FIOCRUZ Minas, Belo Horizonte, Minas Gerais, Brazil
| | - Camilla V. Pires
- Center for Global Health and Infectious Diseases Research, Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida, United States of America
| | - Talita A. F. Monteiro
- Instituto Evandro Chagas, Secretaria de Vigilância em Saúde, Ministério da Saúde (IEC/SVS/MS), Belém, Pará, Brazil
| | - Jaap M. Middeldorp
- Department of Pathology, Free University Medical Center, Amsterdam, The Netherlands
| | - Irene S. Soares
- Faculdade de Ciências Farmacêuticas, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Cor J. F. Fontes
- Julio Müller School Hospital, Faculdade de Medicina, Universidade Federal de Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Francis B. Ntumngia
- Center for Global Health and Infectious Diseases Research, Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida, United States of America
| | - John H. Adams
- Center for Global Health and Infectious Diseases Research, Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida, United States of America
| | - Flora S. Kano
- Instituto René Rachou/FIOCRUZ Minas, Belo Horizonte, Minas Gerais, Brazil
| | - Luzia H. Carvalho
- Instituto René Rachou/FIOCRUZ Minas, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| |
Collapse
|
14
|
SELLAM I, ABDOUH S, ABOUHALI I, AKSIM M, ELFANE M. [Spinal cord compression secondary to metastasis of gingival Burkitt lymphoma revealing a case of HIV infection in Morocco]. Med Trop Sante Int 2022; 2:mtsi.v2i1.2022.203. [PMID: 35685841 PMCID: PMC9128413 DOI: 10.48327/mtsi.v2i1.2022.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 01/04/2022] [Indexed: 06/15/2023]
Abstract
Burkitt lymphoma in HIV-infected patients is seldom seen in the oral cavity, and they are rarely reported in the literature. The clinical manifestations may suggest other tumors or gingival infections, which delays diagnosis and management. Spinal cord involvement is exceptional and only a few cases are reported. We report a case of Burkitt lymphoma in the oral cavity and spinal cord, revealing HIV infection in a 44-year-old patient, who responded well to chemotherapy and antiretroviral treatment and is on remission.
Collapse
Affiliation(s)
- Imane SELLAM
- Service des maladies infectieuses, Faculté de médecine et de pharmacie, Université Ibn Zohr, Agadir, Maroc
| | - Soufiane ABDOUH
- Service des maladies infectieuses, Faculté de médecine et de pharmacie, Université Ibn Zohr, Agadir, Maroc
| | - Ibrahim ABOUHALI
- Service des maladies infectieuses, Faculté de médecine et de pharmacie, Université Ibn Zohr, Agadir, Maroc
| | - Mohamed AKSIM
- Service des maladies infectieuses, Faculté de médecine et de pharmacie, Université Ibn Zohr, Agadir, Maroc
| | - Mouna ELFANE
- Service des maladies infectieuses, Faculté de médecine et de pharmacie, Université Ibn Zohr, Agadir, Maroc
| |
Collapse
|
15
|
Xu N, Yang XF, Xue SL, Tan JW, Li MH, Ye J, Lou XY, Yu Z, Kang LQ, Yan ZQ, Yu L, Chen SN, Wang YT. Ruxolitinib reduces severe CRS response by suspending CAR-T cell function instead of damaging CAR-T cells. Biochem Biophys Res Commun 2022; 595:54-61. [PMID: 35101664 DOI: 10.1016/j.bbrc.2022.01.070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/18/2022] [Indexed: 12/26/2022]
Abstract
The therapeutic effect of CAR-T is often accompanied by sCRS, which is the main obstacle to the promotion of CAR-T therapy. The JAK1/2 inhibitor ruxolitinib has recently been confirmed as clinically effective in maintaining control over sCRS, however, its mechanism remains unclear. In this study, we firstly revealed that ruxolitinib significantly inhibited the proliferation of CAR-T cells without damaging viability, and induced an efficacy-favored differentiation phenotype. Second, ruxolitinib reduced the level of cytokine release not only from CAR-T cells, but also from other cells in the immune system. Third, the cytolytic activity of CAR-T cells was restored once the ruxolitinib was removed; however, the cytokines released from the CAR-T cells maintained an inhibited state to some degree. Finally, ruxolitinib significantly reduced the proliferation rate of CAR-T cells in vivo without affecting the therapeutic efficacy after withdrawal at the appropriate dose. We demonstrated pre-clinically that ruxolitinib interferes with both CAR-T cells and the other immune cells that play an important role in triggering sCRS reactions. This work provides useful and important scientific data for clinicians on the question of whether ruxolitinib has an effect on CAR-T cell function loss causing CAR-T treatment failure when applied in the treatment of sCRS, the answer to which is of great clinical significance.
Collapse
Affiliation(s)
- Nan Xu
- Institute of Biomedical Engineering and Technology, Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai, China
| | - Xiao-Fei Yang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Sheng-Li Xue
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Jing-Wen Tan
- Institute of Biomedical Engineering and Technology, Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai, China
| | - Ming-Hao Li
- Institute of Biomedical Engineering and Technology, Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai, China
| | - Jing Ye
- Shanghai Unicar-Therapy Bio-medicine Technology Co., Ltd, Shanghai, China
| | - Xiao-Yan Lou
- Shanghai Unicar-Therapy Bio-medicine Technology Co., Ltd, Shanghai, China
| | - Zhou Yu
- Shanghai Unicar-Therapy Bio-medicine Technology Co., Ltd, Shanghai, China
| | - Li-Qing Kang
- Shanghai Unicar-Therapy Bio-medicine Technology Co., Ltd, Shanghai, China
| | - Zhi-Qiang Yan
- Institute of Biomedical Engineering and Technology, Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai, China
| | - Lei Yu
- Institute of Biomedical Engineering and Technology, Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai, China; Shanghai Unicar-Therapy Bio-medicine Technology Co., Ltd, Shanghai, China
| | - Su-Ning Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
| | - Yi-Ting Wang
- Institute of Biomedical Engineering and Technology, Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai, China.
| |
Collapse
|
16
|
Terada I, Hashimoto M, Zaimoku R, Takei R, Terakawa H, Tsukioka Y, Kiriyama M. [A Case of Cecal Burkitt's Lymphoma with Intussusception]. Gan To Kagaku Ryoho 2022; 49:220-222. [PMID: 35249067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We report a case of ileocecal intussusception due to Burkitt's lymphoma(BL). A 14-year-old boy was admitted to our hospital for abdominal pain and diarrhea. He was diagnosed an intussusception by the ultrasonography and the CT scan. Laparoscopic ileocecal resection was performed. A diagnosis of BL was made on basis of pathological examination. He was transferred for the chemotherapy on postoperative day 8. We conclude that, if the intussusception associated with malignant lymphoma is assumed from the preoperative findings, we have to keep minimal surgical invasion and start postoperative chemotherapy immediately.
Collapse
|
17
|
Sun S, Levy DM, Levy M, Crawford JR. Burkitt lymphoma of the cavernous sinus presenting with acute onset third nerve palsy. BMJ Case Rep 2022; 15:e248086. [PMID: 35039382 PMCID: PMC8768918 DOI: 10.1136/bcr-2021-248086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Scott Sun
- Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Danielle M Levy
- Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Michael Levy
- Neurosurgery, University of California San Diego, San Diego, California, USA
| | - John Ross Crawford
- Neurosciences and Pediatrics, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
18
|
Jain A, Arun VA, Bal A, Malhotra P. Primary chest wall Burkitt lymphoma in a case of HIV infection with immune reconstitution. BMJ Case Rep 2021; 14:e243873. [PMID: 34969787 PMCID: PMC8719129 DOI: 10.1136/bcr-2021-243873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/03/2022] Open
Abstract
Burkitt lymphoma (BL) develops at an increased frequency in patients with HIV irrespective of the CD4 count. Lymph nodes and gastrointestinal tract are common sites of involvement by BL; however, primary chest wall BL is rare. A 52-year-old man on highly active antiretroviral therapy (HAART) for HIV with a CD4 count of 0.204 x 109 cells/L presented with a 3-month history of enlarging chest wall mass. PET-CT scan imaging showed a bulky mass involving the musculoskeletal planes of left chest wall with the involvement of underlying pleura. Biopsy with immunohistochemistry confirmed BL. Patient received EPOCH-R (infusional etoposide, vincristine, and doxorubicin with prednisone, cyclophosphamide and rituximab) regime for six cycles along with HAART, attained complete remission (CR) and remains free of BL at 5 years. BL should be considered in the differential diagnosis of soft tissue masses in HIV-infected patients irrespective of their CD4 count.
Collapse
Affiliation(s)
- Arihant Jain
- Department of Clinical Hematology and Medical Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Amanjit Bal
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Department of Clinical Hematology and Medical Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
19
|
Lin Y, Pan YH, Li MK, Zong XD, Pan XM, Tan SY, Guo YW. Clinical presentation of gastric Burkitt lymphoma presenting with paraplegia and acute pancreatitis: A case report. World J Gastroenterol 2021; 27:7844-7854. [PMID: 34963746 PMCID: PMC8661376 DOI: 10.3748/wjg.v27.i45.7844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/11/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The incidence of gastric Burkitt lymphoma (BL), presenting as paraplegia and acute pancreatitis, is extremely low. BL is a great masquerader that presents in varied forms and in atypical locations, and it is prone to misdiagnosis and missed diagnosis. The prognosis of BL remains poor because of the difficulty in early diagnosis and the limited advances in chemotherapy.
CASE SUMMARY A 53-year-old man was referred to our hospital from the local county hospital due to abdominal pain for two weeks and weakness in the lower extremities for one day. Magnetic resonance imaging of the abdomen and lumbar spine showed a swollen pancreas and gallbladder, with peripancreatic exudation and liquid collection, indicating acute pancreatitis and acute cholecystitis. Additionally, we observed abnormally thickened lesions of the gastric wall, multiple enlarged retroperitoneal lymph nodes and a well-demarcated, posterolateral extradural mass lesion between T9 and T12, with extension through the spinal foramen and definite bony destruction, suggesting metastasis in gastric malignancy. Subsequent whole-body positron emission tomography/computed tomography examination showed multifocal malignant lesions in the stomach, pancreas, gallbladder, bone, bilateral supraclavicular fossa, anterior mediastinum, bilateral axillary and retroperitoneal lymph nodes. Gastroduodenal endoscopy revealed primary BL with massive involvement of the gastric body and duodenum. The patient refused chemotherapeutic treatment and died one week later due to upper gastrointestinal hemorrhage. Afterward, we reviewed the characteristics of 11 patients with BL involving the stomach, pancreas or spinal cord.
CONCLUSION Clinicians should be aware that BL can be the potential cause of acute pancreatitis or a rapidly progressive spinal tumor with accompanying paraplegia. For gastric BL, gastroscopy biopsies and pathology are necessary for a definite diagnosis.
Collapse
Affiliation(s)
- Ying Lin
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Yu-Hang Pan
- Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Ming-Kai Li
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Xiao-Dan Zong
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Xue-Mei Pan
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Shu-Yan Tan
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| | - Yun-Wei Guo
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
| |
Collapse
|
20
|
Hérnandez Jimenez CA, Schlie Villa W, Ordinola Navarro A. Cardiac Burkitt's lymphoma presenting with heart failure. QJM 2021; 114:589-590. [PMID: 33713134 DOI: 10.1093/qjmed/hcab053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- C A Hérnandez Jimenez
- Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, 02990 Azcapotzalco, Mexico City, Mexico
| | - W Schlie Villa
- Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, 02990 Azcapotzalco, Mexico City, Mexico
| | - A Ordinola Navarro
- Department of Internal Medicine, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Calle Seris y Zaachila, La Raza, 02990 Azcapotzalco, Mexico City, Mexico
| |
Collapse
|
21
|
Biernat MM, Wróbel T. Bacterial Infection and Non-Hodgkin B-Cell Lymphoma: Interactions between Pathogen, Host and the Tumor Environment. Int J Mol Sci 2021; 22:ijms22147372. [PMID: 34298992 PMCID: PMC8305669 DOI: 10.3390/ijms22147372] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/23/2021] [Accepted: 07/07/2021] [Indexed: 02/06/2023] Open
Abstract
Non-Hodgkin B-cell lymphomas (NHL) are a heterogeneous group of lymphoid neoplasms with complex etiopathology, rich symptomatology, and a variety of clinical courses, therefore requiring different therapeutic approaches. The hypothesis that an infectious agent may initiate chronic inflammation and facilitate B lymphocyte transformation and lymphogenesis has been raised in recent years. Viruses, like EBV, HTLV-1, HIV, HCV and parasites, like Plasmodium falciparum, have been linked to the development of lymphomas. The association of chronic Helicobacter pylori (H. pylori) infection with mucosa-associated lymphoid tissue (MALT) lymphoma, Borrelia burgdorferi with cutaneous MALT lymphoma and Chlamydophila psittaci with ocular adnexal MALT lymphoma is well documented. Recent studies have indicated that other infectious agents may also be relevant in B-cell lymphogenesis such as Coxiella burnettii, Campylobacter jejuni, Achromobacter xylosoxidans, and Escherichia coli. The aim of the present review is to provide a summary of the current literature on infectious bacterial agents associated with B-cell NHL and to discuss its role in lymphogenesis, taking into account the interaction between infectious agents, host factors, and the tumor environment.
Collapse
MESH Headings
- Bacterial Infections/complications
- Bacterial Infections/immunology
- Burkitt Lymphoma/complications
- Burkitt Lymphoma/microbiology
- Burkitt Lymphoma/pathology
- Carcinogenesis/genetics
- Carcinogenesis/immunology
- Carcinogenesis/metabolism
- Helicobacter Infections/complications
- Helicobacter Infections/microbiology
- Helicobacter pylori/pathogenicity
- Host-Pathogen Interactions/genetics
- Host-Pathogen Interactions/immunology
- Humans
- Lymphoma, B-Cell, Marginal Zone/complications
- Lymphoma, B-Cell, Marginal Zone/microbiology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/microbiology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Tumor Microenvironment/genetics
- Tumor Microenvironment/immunology
Collapse
|
22
|
Goel AN, Filimonov A, Teruya-Feldstein J, Salib C, Rousso JJ, Hackett AM, Rothschild MA, Wanna GB. Burkitt lymphoma of the nasopharynx causing life-threatening airway obstruction: A case report. Am J Otolaryngol 2021; 42:102977. [PMID: 33636684 DOI: 10.1016/j.amjoto.2021.102977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/13/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe a case of Burkitt lymphoma (BL) in a child manifesting with acute airway obstruction. To review available literature on the clinical features and characteristic presentation of this disease. METHODS Case report with literature review. RESULTS We present the case of an 8-year-old boy with nasopharyngeal BL manifesting initially as sore throat, nasal congestion, and snoring that progressed to dyspnea and, ultimately, acute airway obstruction requiring emergent tracheostomy. The child was treated with intensive chemotherapy and achieved complete response. CONCLUSION This case highlights the importance of maintaining high clinical suspicion when evaluating common otolaryngologic symptoms and emphasizes the potential for Burkitt lymphoma to cause rapid patient deterioration.
Collapse
Affiliation(s)
- Alexander N Goel
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA.
| | - Andrey Filimonov
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA
| | | | - Christian Salib
- Department of Pathology, Icahn School of Medicine at Mount Sinai, NY, New York, USA
| | - Joseph J Rousso
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA
| | - Alyssa M Hackett
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA
| | - Michael A Rothschild
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA
| | - George B Wanna
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA
| |
Collapse
|
23
|
Kanamaru K, Hisamatsu C, Osuga T, Ikura Y. Endoscopic detection of the lead-point of intussusception associated with ileal Burkitt's lymphoma. Dig Liver Dis 2021; 53:652-653. [PMID: 32561302 DOI: 10.1016/j.dld.2020.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/16/2020] [Accepted: 05/18/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Kaoruko Kanamaru
- Department of Gastroenterology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki 569-1192, Japan; Department of Pathology, Takatsuki General Hospital, Takatsuki, Japan
| | - Chieko Hisamatsu
- Department of Pediatric Surgery, Takatsuki General Hospital, Takatsuki, Japan
| | - Tatsuya Osuga
- Department of Gastroenterology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki 569-1192, Japan
| | - Yoshihiro Ikura
- Department of Pathology, Takatsuki General Hospital, Takatsuki, Japan.
| |
Collapse
|
24
|
Barradas P, Esteireiro AS, Carvalho S, Brito MJ. Wernicke encephalopathy in a patient with Burkitt lymphoma with typical and atypical findings on MRI. BMJ Case Rep 2021; 14:e239392. [PMID: 33541942 PMCID: PMC7868286 DOI: 10.1136/bcr-2020-239392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2021] [Indexed: 02/06/2023] Open
Affiliation(s)
- Pedro Barradas
- Neuroradiology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Coimbra, Portugal
| | - Ana Sofia Esteireiro
- Paedeatrics, Centro Hospitalar do Oeste Unidade de Caldas da Rainha, Caldas da Rainha, Portugal
| | - Silvia Carvalho
- Neuroradiology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Coimbra, Portugal
| | - Manuel João Brito
- Pedeatric Oncology, Centro Hospitalar e Universitario de Coimbra EPE Hospital Pediátrico de Coimbra, Coimbra, Coimbra, Portugal
| |
Collapse
|
25
|
Fiordaliso M, Panaccio P, Costantini R, De Marco AF. Comparison between children and adults intussusception. Description of two cases and review of literature. Ann Ital Chir 2021; 92:268-276. [PMID: 34031279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Intussusception is a common condition in children, it is rare in adults. Adult intussusception differs from pediatric intussusception in various respects, including etiology clinical characteristics and therapy. METHODS We present and discuss a new case of intussusception in children and adults. RESULTS In child the Barium Enema x-ray examination is identified an endoluminal filling defect to refer to the apex of the invaginated loop at the rectal level, with slow ascent during the progressive injection of the radiopaque contrast medium. At the end of the procedure, incomplete reduction of the picture is documented. The patient undergoes emergency surgery where the presence of an ileo-ceco-colic invagination is documented. Intussusception is reduced by taxis. In the adult laparoscopic right hemicolectomy was performed. High-grade B-cell Burkitt's lymphoma was confirmed by immunohistochemistry. DISCUSSION In contrast to intussusceptions in children, in the adult population, a demonstrable etiology is found in most of the cases. In adults surgery is always indicated. The non-invasive resolutive intervention most commonly used in the child and best known consists in the rectal introduction of a radiopaque contrast medium (air or barium) at controlled pressure until. CONCLUSIONS Although intussusceptions occur at all ages, there are major differences in the clinical presentation, diagnostic approach, and management between pediatric and adult populations. Intussusception is remarkably different in these two age groups and it must be approached from a different clinical perspective. KEY WORDS Intussusception in children, Intussusception in adults, Intussusception symptoms, Radiology and treatment.
Collapse
|
26
|
Birlutiu V, Birlutiu RM, Zaharie IS, Sandu M. Burkitt lymphoma associated with human immunodeficiency virus infection and pulmonary tuberculosis: A case report. Medicine (Baltimore) 2020; 99:e23853. [PMID: 33350777 PMCID: PMC7769298 DOI: 10.1097/md.0000000000023853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 10/28/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The association of human immunodeficiency virus (HIV) infection with Burkitt lymphoma is related to the presence of Epstein Barr virus infection and the impact of the HIV antigen on the expansion of B-polyclonal cells. In Southeast Europe, the association is rare, and recognizing this is important in the therapeutic decision to increase patient survival rate. The association of HIV with Burkitt lymphoma and tuberculosis is even more rarely described in the literature. PATIENT CONCERNS We present the case of a 40-year-old patient who presented with a 3-week history of fever (max. 38.7 °C), painful axillary swelling on the right side, lumbar pain, gait disorders, headache, and night sweats. Clinical manifestations included marked weight loss (about 30 kg in the last 2 months before his admission). DIAGNOSIS A LyCD4 count of 38/μL and a HIV1 viral load of 384,000/mm3, classified the patient into a C3 stage. A biopsy of the right axillary lymph node was performed for suspected ganglionic tuberculosis due to immunodeficiency. Histopathological examination confirmed the diagnosis of Burkitt lymphoma. Cultures on Löwenstein-Jensen medium from sputum harvested at first admission were positive for Mycobacterium tuberculosis. INTERVENTIONS Highly active antiretroviral therapy, chemotherapeutic agents for Burkitt lymphoma, anti-tuberculous drug therapy, neurosurgical intervention of spinal cord decompression, and antibiotic therapy of the associated bacterial infection. OUTCOME Burkitt lymphoma disseminated rapidly, with central nervous system, spinal cord, osteomuscular, adrenal, and spleen involvement. The evolution under treatment was unfavorable, with patient death occurring 6 months after diagnosis. CONCLUSIONS The association of HIV infection with Burkitt lymphoma and tuberculosis is rare in the highly active antiretroviral therapy (HAART) era, posing prompt and multidisciplinary therapeutic management issues. Similar cases of HIV-TB and Burkitt lymphoma association have been described, but none of the other cases showed the involvement of the central nervous system or of the bilateral adrenal glands.
Collapse
Affiliation(s)
- Victoria Birlutiu
- Faculty of Medicine Sibiu, Academic Emergency Hospital Sibiu, Romania - Infectious Diseases Clinic
| | - Rares-Mircea Birlutiu
- Faculty of Medicine, “FOISOR” Clinical Hospital of Orthopedics, Traumatology and Osteoarticular TB Bucharest, Lucian Blaga University of Sibiu
| | | | - Mariana Sandu
- Department of Radiology and Medical Imaging, Academic Emergency Hospital Sibiu, Sibiu, Romania
| |
Collapse
|
27
|
Clark E, Royse KE, Dong Y, Chang E, Raychaudhury S, Kramer J, White DL, Chiao E. Stable Incidence and Poor Survival for HIV-Related Burkitt Lymphoma Among the US Veteran Population During the Antiretroviral Era. J Acquir Immune Defic Syndr 2020; 84:18-25. [PMID: 32251095 PMCID: PMC7793609 DOI: 10.1097/qai.0000000000002303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Despite advances in diagnosis and treatment of both HIV and Burkitt lymphoma (BL), persons living with HIV remain at high risk for BL. We conducted this study to evaluate if there have been any changes in the risk of or survival after BL diagnosis among persons living with HIV during the antiretroviral era. SETTING Veterans living with HIV (VLWH) and age-matched HIV-negative controls receiving care between 1999 and 2016 were retrospectively identified using Veterans Health Administration electronic medical records. METHODS We identified BL diagnoses through Veterans Health Administration Cancer Registry review and International Classification of Diseases, Ninth/Tenth Revisions, codes, and we extracted demographic, lifestyle, and clinical variables from electronic medical record. We estimated hazard ratios (HR) and 95% confidence intervals (CIs) for BL risk and survival using Cox proportional models. RESULTS We identified 45,299 VLWH. Eighty-four developed BL (incidence rate = 21.2 per 100,000 person years; CI: 17.1 to 26.3). Median CD4 count at BL diagnosis was 238 cells per milliliter (SD: 324.74) and increased over time. Survival was truncated in VLWH with BL (P < 0.05). The risk of BL in VLWH was 38% less in blacks compared with whites (HR: 0.620; CI: 0.393 to 0.979; P = 0.0401). VLWH with an undetectable viral load for at least 40% of follow-up were 74% less likely to develop BL (HR: 0.261; CI: 0.143 to 0.478; P < 0.0001) and 86% less likely to die after diagnosis (HR: 0.141; CI: 0.058 to 0.348; P < 0.0001). CONCLUSIONS BL incidence among VLWH did not improve between 2000 and 2016. Survival after BL diagnosis in VLWH remains dismal as compared with their HIV-negative counterparts, although veterans with prolonged periods of undetectable viral load had improved prognosis.
Collapse
Affiliation(s)
- Eva Clark
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA; Health Services Research, Michael E. DeBakey VA Health Services Research Center of Innovations (IQuESt), Houston, Texas, USA
| | - Kathryn E. Royse
- Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, Texas, USA; Health Services Research, Michael E. DeBakey VA Health Services Research Center of Innovations (IQuESt), Houston, Texas, USA
| | - Yongquan Dong
- Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, Texas, USA; Health Services Research, Michael E. DeBakey VA Health Services Research Center of Innovations (IQuESt), Houston, Texas, USA
| | - Elaine Chang
- Department of Medicine, Section of Hematology and Oncology, Baylor College of Medicine, Houston, Texas, USA; Health Services Research, Michael E. DeBakey VA Health Services Research Center of Innovations (IQuESt), Houston, Texas, USA
| | - Suchismita Raychaudhury
- Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, Texas, USA; Health Services Research, Michael E. DeBakey VA Health Services Research Center of Innovations (IQuESt), Houston, Texas, USA
| | - Jennifer Kramer
- Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, Texas, USA; Health Services Research, Michael E. DeBakey VA Health Services Research Center of Innovations (IQuESt), Houston, Texas, USA; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Donna L. White
- Department of Medicine, Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas, USA; Clinical Epidemiology and Comparative Effectiveness Program at Michael E. DeBakey VA Health Services Research Center of Innovations (IQuESt), Houston, Texas, USA; Center for Translation in Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, Texas, USA; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Elizabeth Chiao
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA; Health Services Research, Michael E. DeBakey VA Health Services Research Center of Innovations (IQuESt), Houston, Texas, USA; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| |
Collapse
|
28
|
Fitzgerald L, Stephens DM. Burkitt Lymphoma Presenting as Cranial Multineuritis Secondary to Primary Neurolymphomatosis: A Diagnostic Challenge. Clin Lymphoma Myeloma Leuk 2020; 20:e201-e204. [PMID: 32113890 DOI: 10.1016/j.clml.2020.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Affiliation(s)
- Lindsey Fitzgerald
- Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.
| | - Deborah M Stephens
- Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| |
Collapse
|
29
|
Junfeng L, Lina M, Xinyue C. Autologous hematopoietic stem cell transplantation for human immunodeficiency virus associated gastric Burkitt lymphoma: A case report. Medicine (Baltimore) 2019; 98:e16222. [PMID: 31335672 PMCID: PMC6708705 DOI: 10.1097/md.0000000000016222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE HIV-related lymphoma, especially non-Hodgkin lymphoma, is one of the most common malignant tumors in HIV/acquired immune deficiency syndrome (AIDS) patients. Autologous hematopoietic stem cell transplantation (AHSCT) for the patients with Burkitt lymphoma (BL) is needed to be further explored. PATIENT CONCERNS A 57-year-old man was hospitalized with intermittent pain on upper abdomen and melena for >1 month. DIAGNOSIS HIV antibody testing was positive. The upper gastrointestinal endoscopy was performed and histopathology and immunohistochemistry revealed BL. INTERVENTIONS Highly effective antiretroviral therapy and sixth cycles of chemotherapy were administered, followed by autologous hematopoietic stem cell transplantation. OUTCOMES The patient has had tumor-free survival for >6 years with normal CD4+ T cell counts and HIV viral load below the lowest detection LESSONS:: The patient was treated with AHSCT followed complete remission after chemotherapy and achieved long-term disease-free survival. AHSCT may be a promising way for clinical cure of HIV-related BL.
Collapse
|
30
|
Abstract
INTRODUCTION Lymphoma is the third most common cancer among children in the United States and Europe. Hemophilia is a congenital bleeding disorder characterized by deficiency of coagulation factor VIII or IX. Hemophilia B is a consequence of factor IX deficiency and has an incidence of 1 in 20,000 male births. A concurrence of these 2 uncommon diseases is rare except in patients infected with the human immunodeficiency virus (HIV). We report a case of a patient with both Burkitt lymphoma and hemophilia B; this is only such report in China since 1987. PATIENT CONCERNS A 3-year-old boy was admitted to our hospital because of melena and jaundice for several days. His older brother had died due to hemophilia B and ventricular septal defect. The patient had not experienced any previous episodes of severe bleeding. Gradual abdominal distention was observed after admission; the patient's superficial lymph nodes were not enlarged. Results of blood routine and bone marrow examinations showed no abnormalities. He was diagnosed with sclerosing cholangitis, abdominal infection, and hepatitis. However, after treatment of reducing enzyme activity and eliminating jaundice, the patient's condition deteriorated. Hydrops abdominis was detected on abdominal ultrasonography. Tumor cells were found by pathological examination of peritoneal effusion. Both a c-myc gene translocation and a c-myc-IgH gene fusion were detected. DIAGNOSIS Burkitt lymphoma and hemophilia B. INTERVENTIONS The patient was transferred to the Pediatric Hematology Department of our hospital and treated with a modified B-NHL-BFM-95 protocol. During chemotherapy, platelet changes were monitored regularly and blood products were infused timely. OUTCOMES The patient died of infection and bleeding after chemotherapy. CONCLUSION Concurrent hemophilia and lymphoma are rare, especially in children. When encountering a patient with unexplained obstructive jaundice and massive ascites, the possibility of a tumor should be considered. Early diagnosis and adequate treatment of such tumor may improve prognosis.
Collapse
Affiliation(s)
- Guoyan Lu
- Department of Pediatric, West China Second University Hospital, Sichuan University, Chengdu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan
| | - Lina Qiao
- Department of Pediatric, West China Second University Hospital, Sichuan University, Chengdu
| | - Deyuan Li
- Department of Pediatric, West China Second University Hospital, Sichuan University, Chengdu
| | - Zhongqiang Liu
- Department of Pediatric, West China Second University Hospital, Sichuan University, Chengdu
| | - Fumin Zhao
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Dan Yu
- Department of Pediatric, West China Second University Hospital, Sichuan University, Chengdu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan
| |
Collapse
|
31
|
Levit B, Dubin D, Neymark M, Gilshtein H. [PERFORATION OF LARGE BOWEL AS FIRST PRESENTATION OF BURKITT'S LYMPHOMA]. Harefuah 2019; 158:237-238. [PMID: 31032555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Barak Levit
- Surgery Department, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Daniel Dubin
- Surgery Department, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Maria Neymark
- Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Hayim Gilshtein
- Surgery Department, Rambam Health Care Campus, Haifa, Israel
| |
Collapse
|
32
|
Retinasekharan S, Sinnathamby P, Mohamad I. Paediatric burkitt lymphoma presenting as a mandible swelling and intussusception. Med J Malaysia 2019; 74:90-91. [PMID: 30846671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Burkitt lymphoma is a rare entity especially in this part of the world. We had an 11-year-old patient presented with swelling of the mandible for a short one-month duration. He was planned for excision biopsy. However developed severe abdominal pain while in the hospital and was diagnosed as intussusception after ultrasound was done. We proceeded with right hemicolectomy and excision of buccal mass. Early recognition and close monitoring of insidious jaw lesions is recommended even in young adults not within the modal age category of endemic Burkitt.
Collapse
Affiliation(s)
- S Retinasekharan
- Penang General Hospital, Department of Otorhinolaryngology, George Town, Pulau Pinang, Malaysia.
| | - P Sinnathamby
- Penang General Hospital, Department of Otorhinolaryngology, George Town, Pulau Pinang, Malaysia
| | - I Mohamad
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology - Head & Neck Surgery, Health Campus, Kota Bharu, Kelantan, Malaysia
| |
Collapse
|
33
|
Ng JYS, Thompson RJ, Lam A, Nigam S. Sporadic Burkitt's lymphoma masquerading as an intussuscepted Meckel's diverticulum in a 9-year-old child. BMJ Case Rep 2018; 2018:bcr-2018-224333. [PMID: 30042102 PMCID: PMC6059232 DOI: 10.1136/bcr-2018-224333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2018] [Indexed: 11/03/2022] Open
Abstract
We report the case of a 9-year-old boy who presented with abdominal pain and was found to have an intussusception with a sporadic Burkitt's lymphoma (BL) lead point. Our case was unusual in that the patient did not present with the typical clinical features of BL, nor was he in a high-risk demographic for this uncommon disease.
Collapse
Affiliation(s)
| | | | - Alfred Lam
- Pathology, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Sonu Nigam
- Pathology, Gold Coast University Hospital, Southport, Queensland, Australia
| |
Collapse
|
34
|
Legason ID, Pfeiffer RM, Udquim KI, Bergen AW, Gouveia MH, Kirimunda S, Otim I, Karlins E, Kerchan P, Nabalende H, Bayanjargal A, Emmanuel B, Kagwa P, Talisuna AO, Bhatia K, Yeager M, Biggar RJ, Ayers LW, Reynolds SJ, Goedert JJ, Ogwang MD, Fraumeni JF, Prokunina-Olsson L, Mbulaiteye SM. Evaluating the Causal Link Between Malaria Infection and Endemic Burkitt Lymphoma in Northern Uganda: A Mendelian Randomization Study. EBioMedicine 2017; 25:58-65. [PMID: 29033373 PMCID: PMC5704046 DOI: 10.1016/j.ebiom.2017.09.037] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 09/16/2017] [Accepted: 09/28/2017] [Indexed: 12/31/2022] Open
Abstract
Background Plasmodium falciparum (Pf) malaria infection is suspected to cause endemic Burkitt Lymphoma (eBL), but the evidence remains unsettled. An inverse relationship between sickle cell trait (SCT) and eBL, which supports that between malaria and eBL, has been reported before, but in small studies with low power. We investigated this hypothesis in children in a population-based study in northern Uganda using Mendelian Randomization. Methods Malaria-related polymorphisms (SCT, IL10, IL1A, CD36, SEMA3C, and IFNAR1) were genotyped in 202 eBL cases and 624 controls enrolled during 2010–2015. We modeled associations between genotypes and eBL or malaria using logistic regression. Findings SCT was associated with decreased risk of eBL (adjusted odds ratio [OR] 0·37, 95% CI 0·21–0·66; p = 0·0003). Decreased risk of eBL was associated with IL10 rs1800896-CT (OR 0·73, 95% CI 0·50–1·07) and -CC genotypes (OR 0·53, 95% CI 0·29–0·95, ptrend = 0·019); IL1A rs2856838-AG (OR 0·56, 95% CI 0·39–0·81) and -AA genotype (OR 0·50, 95% CI 0·28–1·01, ptrend = 0·0016); and SEMA3C rs4461841-CT or -CC genotypes (OR 0·57, 95% CI 0·35–0·93, p = 0·0193). SCT and IL10 rs1800896, IL1A rs2856838, but not SEMA3C rs4461841, polymorphisms were associated with decreased risk of malaria in the controls. Interpretation Our results support a causal effect of malaria infection on eBL. Mendelian randomization analysis was done to assess a causal relationship between malaria infection and endemic Burkitt lymphoma in Uganda Carriage of the sickle cell trait was associated with decreased risk of endemic Burkitt lymphoma Heterozygous or homozygous minor alleles of IL10 rs1800896, IL1A rs2856838, and SEMA3C rs4461841 were associated with decreased risk of endemic Burkitt lymphoma The inverse association between sickle cell trait and endemic Burkitt lymphoma supports a causal role of malaria in endemic Burkitt lymphoma
Collapse
Affiliation(s)
- Ismail D Legason
- EMBLEM Study, African Field Epidemiology Network, P.O. Box 12874, Kampala, Uganda
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Ctr Dr, Bethesda 20892, MD, USA.
| | - Krizia-Ivana Udquim
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Andrew W Bergen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Ctr Dr, Bethesda 20892, MD, USA
| | - Mateus H Gouveia
- Instituto de Pesquisa Rene Rachou, Fundação Oswaldo Cruz, 30190-002 Belo Horizonte, Minas Gerais, Brazil
| | - Samuel Kirimunda
- Department of Medical Microbiology, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Isaac Otim
- EMBLEM Study, African Field Epidemiology Network, P.O. Box 12874, Kampala, Uganda
| | - Eric Karlins
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Ctr Dr, Bethesda 20892, MD, USA.
| | - Patrick Kerchan
- EMBLEM Study, African Field Epidemiology Network, P.O. Box 12874, Kampala, Uganda
| | - Hadijah Nabalende
- EMBLEM Study, African Field Epidemiology Network, P.O. Box 12874, Kampala, Uganda
| | - Ariunaa Bayanjargal
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Benjamin Emmanuel
- EMBLEM Study, African Field Epidemiology Network, P.O. Box 12874, Kampala, Uganda; Benjamin Emmanuel, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Paul Kagwa
- EMBLEM Study, African Field Epidemiology Network, P.O. Box 12874, Kampala, Uganda
| | - Ambrose O Talisuna
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Kishor Bhatia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Ctr Dr, Bethesda 20892, MD, USA.
| | - Meredith Yeager
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Ctr Dr, Bethesda 20892, MD, USA.
| | - Robert J Biggar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Ctr Dr, Bethesda 20892, MD, USA
| | - Leona W Ayers
- Department of Pathology, The Ohio State University, Columbus, OH, USA.
| | - Steven J Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
| | - James J Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Ctr Dr, Bethesda 20892, MD, USA
| | - Martin D Ogwang
- EMBLEM Study, St. Mary's Hospital, Lacor, P.O. Box 180, Gulu, Uganda.
| | - Joseph F Fraumeni
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Ctr Dr, Bethesda 20892, MD, USA.
| | - Ludmila Prokunina-Olsson
- Laboratory of Translational Genomics, 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, 9609 Medical Ctr Dr, Bethesda 20892, MD, USA.
| |
Collapse
|
35
|
Mawson AR, Majumdar S. Malaria, Epstein-Barr virus infection and the pathogenesis of Burkitt's lymphoma. Int J Cancer 2017; 141:1849-1855. [PMID: 28707393 DOI: 10.1002/ijc.30885] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 06/10/2017] [Accepted: 07/07/2017] [Indexed: 02/06/2023]
Abstract
A geographical and causal connection has long been recognized between malaria, Epstein-Barr virus (EBV) infection and Burkitt's lymphoma (BL), but the underlying mechanisms remain obscure. Potential clues are that the malaria parasite Plasmodium falciparum selectively absorbs vitamin A from the host and depends on it for its biological activities; secondly, alterations in vitamin A (retinoid) metabolism have been implicated in many forms of cancer, including BL. The first author has proposed that the merozoite-stage malaria parasite, emerging from the liver, uses its absorbed vitamin A as a cell membrane destabilizer to invade the red blood cells, causing anemia and other signs and symptoms of the disease as manifestations of an endogenous form of hypervitaminosis A (Mawson AR, Path Global Health 2013;107(3):122-9). Repeated episodes of malaria would therefore be expected to expose the tissues of affected individuals to potentially toxic doses of vitamin A. It is proposed that such episodes activate latent EBV infection, which in turn activates retinoid-responsive genes. Expression of these genes enhances viral replication and induces germinal center (GC) B cell expansion, activation-induced cytidine deaminase (AID) expression, and c-myc translocation, which in turn predisposes to BL. Thus, an endogenous form of retinoid toxicity related to malaria infection may be the common factor linking frequent malaria, EBV infection and BL, whereby prolonged exposure of lymphatic tissues to high concentrations of retinoids may combine to induce B-cell translocation and increase the risk of Burkitt's lymphoma.
Collapse
Affiliation(s)
- Anthony R Mawson
- Professor, Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS
| | - Suvankar Majumdar
- Chief, Division of Hematology, Center for Cancer and Blood Disorders, Children's National Medical Center, Associate Professor of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC
| |
Collapse
|
36
|
Abstract
RATIONALE The Burkitt lymphoma (BL) is a very aggressive B-cell non-Hodgkin's lymphoma. It accounts for 34% of lymphoma cases in children. PATIENT CONCERNS We present the case of a 6-year-old boy diagnosed with BL, who presented multiple contrasting elements of the disease: silent symptomatology, without involvement of the bone marrow at first, but with multiorgan infiltration and a fast evolution, despite starting the treatment shortly after the symptoms appeared. DIAGNOSES He was diagnosed with BL after immunophenotyping from the pleural fluid. INTERVENTIONS After a week from admission, chemotherapy was initiated according to protocol NH-BFM therapeutic group III-cytoreductive phase in the acute care ward and subsequently the AA 24 treatment. OUTCOMES Following the treatment, the patient developed medullary aplasia and cutaneous toxicity. The patient's general state remained severe during the hospitalization. LESSONS Even though the prognosis of BL has improved over time (up to 90% survival rate), in this case the evolution was unfavorable. In our patient, the symptoms appeared abruptly. They appeared late in the phase of multiple-organ dissemination, which generated the pessimistic prognosis.
Collapse
Affiliation(s)
| | - Lucian Miron
- Oncology Department, University of Medicine and Pharmacy “Gr. T. Popa”, Iasi, Romania
| | | | | |
Collapse
|
37
|
Araújo J, Sampaio Macedo C, Sousa L. Pancreas Burkitt primary lymphoma in pediatric age. Rev Esp Enferm Dig 2017; 109:451. [PMID: 28597672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We present an the case of an eight-year-old Portuguese boy with no history of traveling, admitted with non-specific abdominal pain. An analytic study revealed high levels of lipase and amylase. Ultrasound, abdominal computerized tomography (CT), and an abdominal magnetic resonance imaging (MRI), were performed. The imaging findings are suggestive of a pancreatic tumor which is an extremely rare entity in children. A biopsy was performed by opened surgery and identified a Burkitt lymphoma.
Collapse
Affiliation(s)
- Joao Araújo
- Radiology, Centro Hospitalar do Porto, PORTUGAL
| | | | | |
Collapse
|
38
|
Sharma P, Balasingham S, Stawiarski K, Rahmani M, Costantino A, Sharma P, Xu M, Masoud A. Burkitt lymphoma as a lead point for jejunojejunal intussusception in a human immunodeficiency virus patient. Clin J Gastroenterol 2017; 10:342-350. [PMID: 28523628 DOI: 10.1007/s12328-017-0747-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 05/05/2017] [Indexed: 11/26/2022]
Abstract
Intussusception is commonly seen in children but is rare in adults and represents only 5% of all intussusceptions causing 1% of intestinal obstructions. More than 50% of these intussusceptions in adults are due to intestinal neoplasms, including malignant lymphoma, e.g., Burkitt lymphoma. These lymphomas are more common in human immunodeficiency virus (HIV)-positive patients than in the general population. We present a case of a young male who was diagnosed with HIV when he developed intestinal obstruction and intussusception secondary to Burkitt lymphoma. He was managed with surgical resection followed by chemotherapy and antiretroviral treatment. HIV patients presenting with acute abdomen pose a diagnostic challenge to clinicians due to a wide range of differential diagnoses including inflammatory, infectious and neoplastic conditions. In a young HIV patient presenting with acute abdomen, intussusception caused by Burkitt lymphoma should be considered in the differential.
Collapse
Affiliation(s)
- Prabin Sharma
- Department of Internal Medicine, Yale New Haven Health, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, USA.
| | - Shivashanker Balasingham
- Department of Internal Medicine, Yale New Haven Health, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, USA
| | - Kristin Stawiarski
- Department of Internal Medicine, Yale New Haven Health, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, USA
| | - Mahboubeh Rahmani
- Department of Pathology, Yale New Haven Hospital, 310 Cedar Street LH 108, New Haven, CT, 06520, USA
| | - Antonio Costantino
- Department of Internal Medicine, Yale New Haven Health, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, USA
| | - Pranav Sharma
- Department of Radiology, Yale University, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, USA
| | - Mina Xu
- Department of Pathology, Yale New Haven Hospital, 310 Cedar Street LH 108, New Haven, CT, 06520, USA
| | - Amir Masoud
- Section of Digestive Diseases, Yale New Haven Hospital, 40 Temple Street, Suite 1A, New Haven, CT, 06510-2715, USA
| |
Collapse
|
39
|
de Freytas A, Rengel Ruiz M, España Gregori E. Proptosis as initial manifestation of Burkitt's lymphoma with orbital involvement. Arch Soc Esp Oftalmol 2017; 92:178-180. [PMID: 27894519 DOI: 10.1016/j.oftal.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/19/2016] [Accepted: 10/24/2016] [Indexed: 06/06/2023]
Abstract
CASE PRESENTATION A 35-year-old woman without any known systemic disorder presented with a complaint of painful and rapidly increasing proptosis in her right eye. Based on the clinical, radiological, analytical and ophthalmological assessments, the diagnosis made was Burkitt's lymphoma in acquired immunodeficiency syndrome. CONCLUSION Proptosis can be an unusual way of presenting with Burkitt's lymphoma associated with acquired immunodeficiency. This differential diagnosis is important because confirmation leads to a change in the vital prognosis of the patient.
Collapse
Affiliation(s)
- A de Freytas
- Servicio de Oftalmología, Hospital Universitario y Politécnico La Fe, Valencia, España.
| | - M Rengel Ruiz
- Servicio de Radiodiagnóstico, Hospital Clínico Universitario de Valencia, Valencia, España
| | - E España Gregori
- Servicio de Oftalmología, Hospital Universitario y Politécnico La Fe, Valencia, España; Sección de Órbita y Oculoplastia, Hospital Universitario y Politécnico La Fe, Valencia, España
| |
Collapse
|
40
|
Ono Y, Kazuma Y, Ochi Y, Matsuoka R, Imai Y, Ishikawa T. Two Cases of Neurolymphomatosis with Fatal Bilateral Vocal Cord Paralysis that were Diagnosed with 18F-fluorodeoxyglucose Positron Emission Tomography (FDG PET)/CT. Intern Med 2017; 56:1193-1198. [PMID: 28502935 PMCID: PMC5491815 DOI: 10.2169/internalmedicine.56.6998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Neurolymphomatosis is a rare entity defined as nerve infiltration by neurotropic abnormal lymphocytes which can lead to the development of neuropathy, with typical presentations including pain, hypoesthesia, paresthesis and palsy. We herein report two cases where critical bilateral vocal cord paralysis due to neurolymphomatosis in recurrent nerves occurred in refractory Burkitt lymphoma and adult T-cell lymphoma patients. High-dose methotrexate and intrathecal chemotherapy injection for the nervous lesions were ineffective, and the patients died. Neurolymphomatosis of the recurrent nerve is an emergent and difficult complication and should be suspected when sudden onset of aphasia, hoarseness or shortness of breath is found in refractory lymphoma patients.
Collapse
Affiliation(s)
- Yuichiro Ono
- Department of Hematology, Kobe City Medical Center General Hospital, Japan
| | | | - Yotaro Ochi
- Department of Hemato-oncology, Kyoto University, Japan
| | - Ryosuke Matsuoka
- Department of Pathology, Kobe City Medical Center General Hospital, Japan
| | - Yukihiro Imai
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, Japan
| |
Collapse
|
41
|
Nelson R. Malaria during pregnancy and risk of Burkitt's lymphoma. Lancet Infect Dis 2016; 16:1232-1233. [PMID: 27788988 DOI: 10.1016/s1473-3099(16)30421-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
42
|
Benayoun E, Badaoui B, Dupuis J, Auger N, Moroch J, Wagner-Ballon O. Alveolar rhabdomyosarcoma mimicking Burkitt-like lymphoma. Ann Hematol 2016; 95:1017-8. [PMID: 27003894 DOI: 10.1007/s00277-016-2646-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 03/15/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Emmanuel Benayoun
- Département d'Hématologie et d'Immunologie Biologiques, APHP, Hôpitaux universitaires Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
| | - Bouchra Badaoui
- Département d'Hématologie et d'Immunologie Biologiques, APHP, Hôpitaux universitaires Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France
- INSERM U955, Equipe 9, IMRB, UPEC, 8 Rue du Général Sarrail, 94000, Créteil, France
| | - Jehan Dupuis
- Unité d'Hémopathies lymphoïdes, APHP, Hôpitaux universitaires Henri Mondor, Créteil, France
| | - Nathalie Auger
- Institut Gustave Roussy, Laboratoire de Cytogénétique, Villejuif, France
| | - Julien Moroch
- Département de Pathologie, APHP, Hôpitaux universitaires Henri Mondor, Créteil, France
| | - Orianne Wagner-Ballon
- Département d'Hématologie et d'Immunologie Biologiques, APHP, Hôpitaux universitaires Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.
- INSERM U955, Equipe 9, IMRB, UPEC, 8 Rue du Général Sarrail, 94000, Créteil, France.
| |
Collapse
|
43
|
Mattioni J, Portnoy JE, Moore JE, Carlson D, Sataloff RT. Laryngotracheal mucormycosis: Report of a case. Ear Nose Throat J 2016; 95:29-39. [PMID: 26829683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Airway mucormycosis is a deadly opportunistic infection that affects immunocompromised persons, particularly diabetics and those undergoing chemotherapy. Although it is typically a pulmonary or sinonasal infection, mucormycosis can affect the larynx and trachea, with devastating results. We report the case of a 46-year-old man with human immunodeficiency virus infection, hepatitis C infection, neurosyphilis, and recently diagnosed Burkitt lymphoma who presented with dysphonia and stridor after receiving one dose of intrathecal chemotherapy. Flexible laryngoscopy detected the presence of fibrinous material that was obstructing nearly the entire glottis. Surgical debridement revealed a firm mucosal attachment; there was little bleeding when it was removed. After debridement, the patient's dyspnea improved only to recur 2 days later. After an awake tracheotomy, laryngoscopy and bronchoscopy identified necrosis extending from the supraglottic area to the carina tracheae. Biopsies demonstrated hyphal architecture consistent with mucormycosis. Despite continued debridements, the fibrinous material reaccumulated. The patient was placed in hospice care; his airway remained patent, but he died from other causes several weeks after presentation. The management of airway mucormycosis is challenging and complex. Fungal airway infections should be considered in the differential diagnosis of an immunosuppressed patient who presents with dyspnea, dysphonia, and vocal fold immobility. Timely diagnosis and management are critical for a successful outcome, although the prognosis is poor if the infection is widespread, even with the best of efforts.
Collapse
Affiliation(s)
- Jillian Mattioni
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, 219 N. Broad St., Philadelphia, PA 19107, USA
| | | | | | | | | |
Collapse
|
44
|
Burkitt’s Lymphoma: Thorax to Pelvis. Indian J Chest Dis Allied Sci 2016; 58:49-51. [PMID: 28393514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Burkitt’s lymphoma is a sub-group of non-Hodgkin’s lymphoma of high-grade with an aggressive clinical course and is composed of diffuse, small and non-cleaved, undifferentiated malignant cells of lymphoid origin. Dennis Burkitt first described this entity in 1956 in equatorial Africa. It is one of the fastest growing cancers in humans with a growth fraction close to 100%. It commonly occurs in children and young adults, with frequent involvement of bone marrow and central nervous system. These are considered to be medical emergencies and require immediate diagnostic and therapeutic intervention. In this report, we present a case of Burkitt’s lymphoma with unusual presentation with the involvement of both thorax and the whole of the abdomen.
Collapse
|
45
|
Mizuno Y, Shimura Y, Horiike S, Takimoto T, Maegawa S, Tanba K, Matsumura-Kimoto Y, Sumida Y, Tatekawa S, Tsukamoto T, Chinen Y, Mizutani S, Nagoshi H, Yamamoto-Sugitani M, Matsumoto Y, Kobayashi T, Kuroda J, Taniwaki M. Burkitt Lymphoma Preceded by Autoimmune Hemolytic Anemia due to Anti-D Antibody. Intern Med 2016; 55:2253-8. [PMID: 27523004 DOI: 10.2169/internalmedicine.55.6564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report a rare case of Burkitt lymphoma (BL) preceded by autoimmune hemolytic anemia (AIHA) caused by autoantibodies against D antigen. After a partial response to AIHA with prednisolone (PSL) treatment for 7 months, the patient developed BL with a t(8;22)(q24;q11.2) chromosomal translocation. Intensive immunochemotherapy, including rituximab, led to a complete response (CR) of BL; however, anti-D antibody remained detectable in the plasma and antibody-dissociated solution from erythrocytes, thus continuous therapy with PSL was necessary even after achievement of the CR. BL with AIHA is extremely rare, with only one previously reported case in the literature.
Collapse
Affiliation(s)
- Yoshimi Mizuno
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Kaymak Cihan M, Kandemir O, Dalva K, Sarı N, Kurucu N, Ergürhan İlhan İ. Can Burkitt's Lymphoma and Hodgkin's Lymphoma occur in siblings simultaneously? Turk J Pediatr 2015; 57:536-540. [PMID: 27411427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Familial clustering of Hodgkin lymphoma (HL) and increased risk of developing disease among the siblings has been reported earlier. Usually familial lymphoma in sibling pairs occurs in the pairs of either non-Hodgkin lymphoma or HL. In the familial HL, same type of human leukocyte antigens (HLA) is responsible in the affected family members. There are also some studies stating "Killer cell immunoglobulin like receptor (KIR)" genotypes can be important in the etiology of familial HL. Here we report two siblings; one with Non-Hodgkin and the other with Hodgkin lymphoma which showed Epstein-Barr virus encoded small RNAs positivity in the tumor tissues. We have also found that their HLA genotypes are same with each other. In addition, we have discussed familial lymphoma pathogenesis and HLA haplotypes.
Collapse
Affiliation(s)
- Meriç Kaymak Cihan
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
| | | | | | | | | | | |
Collapse
|
47
|
Santos-Bueso E, Asorey-García A, Gegúndez-Fernández JA, Vinuesa-Silva JM, García-Sánchez J. Papilledema secondary to Burkitt lymphoma. Arch Soc Esp Oftalmol 2015; 90:396-397. [PMID: 24480465 DOI: 10.1016/j.oftal.2013.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 12/16/2013] [Indexed: 06/03/2023]
Affiliation(s)
- E Santos-Bueso
- Unidad de Neurooftalmología, Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, España.
| | - A Asorey-García
- Unidad de Neurooftalmología, Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - J A Gegúndez-Fernández
- Unidad de Neurooftalmología, Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - J M Vinuesa-Silva
- Cátedra de Oftalmología, Universidad de Salamanca, Salamanca, España
| | - J García-Sánchez
- Unidad de Neurooftalmología, Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, España
| |
Collapse
|
48
|
Simbiri KO, Smith NA, Otieno R, Wohlford EEM, Daud II, Odada SP, Middleton F, Rochford R. Epstein-Barr virus genetic variation in lymphoblastoid cell lines derived from Kenyan pediatric population. PLoS One 2015; 10:e0125420. [PMID: 25933165 PMCID: PMC4416826 DOI: 10.1371/journal.pone.0125420] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 03/23/2015] [Indexed: 11/30/2022] Open
Abstract
Epstein-Barr virus (EBV) is associated with Burkitt’s lymphoma (BL), and in regions of sub-Saharan Africa where endemic BL is common, both the EBV Type 1 (EBV-1) and EBV Type 2 strains (EBV-2) are found. Little is known about genetic variation of EBV strains in areas of sub-Saharan Africa. In the present study, spontaneous lymphoblastoid cell lines (LCLs) were generated from samples obtained from Kenya. Polymerase chain reaction (PCR) amplification of the EBV genome was done using multiple primers and sequenced by next-generation sequencing (NGS). Phylogenetic analyses against the published EBV-1 and EBV-2 strains indicated that one sample, LCL10 was closely related to EBV-2, while the remaining 3 LCL samples were more closely related to EBV-1. Moreover, single nucleotide polymorphism (SNP) analyses showed clustering of LCL variants. We further show by analysis of EBNA-1, BLLF1, BPLF1, and BRRF2 that latent genes are less conserved than lytic genes in these LCLs from a single geographic region. In this study we have shown that NGS is highly useful for deciphering detailed inter and intra-variations in EBV genomes and that within a geographic region different EBV genetic variations can co-exist, the implications of which warrant further investigation. The findings will enhance our understanding of potential pathogenic variants critical to the development and maintenance of EBV-associated malignancies.
Collapse
Affiliation(s)
- Kenneth O. Simbiri
- Department of Microbiology and Immunology, Upstate Medical University, Syracuse, New York, United States of America
- * E-mail:
| | - Nicholas A. Smith
- Department of Microbiology and Immunology, Upstate Medical University, Syracuse, New York, United States of America
| | | | - Eric E. M. Wohlford
- Department of Microbiology and Immunology, Upstate Medical University, Syracuse, New York, United States of America
| | | | | | - Frank Middleton
- Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, New York, United States of America
| | - Rosemary Rochford
- Department of Microbiology and Immunology, Upstate Medical University, Syracuse, New York, United States of America
| |
Collapse
|
49
|
Abstract
Glomerular lesions have been recognized in nearly all forms of malignant diseases. The incidence within each category of malignancy varies substantially but in most series represents less than 2% of the population. While there is a considerable variety of glomerular lesions, a number of general statements may be made. In Hodgkin's disease and other lymphomas, the most common lesion is minimal lesion nephrotic syndrome, reflecting possibly an anomaly of T cell function. Amyloidosis which used to be the commonest lesion has nearly disappeared. On the other hand, in patients with chronic lymphocytic leukemia a large proportion of glomerular lesions fall into the category of proliferative glomerulonephritis. In carcinoma the vast majority of glomerular lesions with proteinuria or the nephrotic syndrome are due to membranous glomerulonephritis. This suggests either a local alteration of fixed glomerular antigens, or localization of tumor antigens planted in the glomeruli leading to the formation of local immunocomplexes. Amyloid AA is still frequent in carcinoma and complicates as much as 3% of renal adenocarcinomas.
Collapse
|
50
|
Erol C, Köse D, Yüksekkaya HA, Köksal Y. Acute pancreatitis due to pancreatic involvement of Burkitt’s lymphoma in a child. Turk J Gastroenterol 2015; 26:67-8. [PMID: 25698277 DOI: 10.5152/tjg.2015.3631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Cengiz Erol
- Department of Radiology, Selçuk University Faculty of Medicine, Konya, Turkey.
| | | | | | | |
Collapse
|