Primary Burkitt lymphoma of the supraglottic larynx: a case report and review of the literature

Burkitt lymphoma in a scalp region: a case report of it's recurrence in a 13-year-old child

Introduction

Burkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma characterized by chromosome 8 MYC gene translocation. It manifests in three clinical types: immunodeficiency-related, sporadic (nonendemic), and endemic (African), each differing in epidemiology and clinical behavior. Treatment typically involves enrollment in clinical trials or intensive chemotherapy regimens like R-CODOX-M/IVAC. The authors present a case of recurrent BL following treatment.

Case report

A 13-year-old female presented with a gradually progressive swelling in the left parieto-occipital region. Examination revealed normal vital signs and a Glasgow coma scale, with seronegative findings on investigations. An excision of a subganglion soft tissue tumor was performed, revealing histopathological features suggestive of a small round blue cell tumor. After chemotherapy, the patient experienced a recurrence in the scalp region, diagnosed as BL.

Discussion

While scarce reports exist on BL in the scalp region, cases have been documented in various body locations. Treatment strategies, including chemotherapy and surgery, have shown promising results in managing the disease and improving symptoms.

Conclusion

The recurrence of BL is rare, highlighting the importance of vigilance in monitoring patients post-treatment. The authors report a case of recurrent BL in a 13-year-old female, emphasizing the need for continued research and surveillance in managing this aggressive malignancy.

Laryngeal Anaplastic Lymphoma Kinase-Positive B-cell Lymphoma: Case Report and Review

Larynx is an uncommon extranodal site for non-Hodgkin lymphoma (NHL). Anaplastic lymphoma kinase (ALK)-positive B-cell lymphoma is a rare and aggressive form of NHL. A 19-year-old male presented to the ENT department with globus sensation, hoarseness, cervical lymphadenopathy and weight loss. A 70-degree rigid endoscopic examination of the larynx showed a vascular, irregular, submucosal mass arising from the right aryepiglottic fold causing near complete obstruction of the laryngeal airway. PET-CT showed hypermetabolic lesions in the supraglottis, cervical lymph nodes, cervical spine, ribs and abdominal lymph nodes. Biopsy was taken from the supraglottic mass as well as the enlarged cervical lymph nodes, which revealed ALK-positive large B-cell NHL. In this report, we present a rare case of ALK-positive large B-cell NHL of the larynx, discussing its clinical, radiological and pathological features. A limited review of literature is also presented. There is a need to develop a database for the description of lymphomas affecting the larynx and this case report adds to the existing knowledge of this rare entity.

Non-squamous Laryngeal Cancer

The pathology of non-squamous carcinoma of the larynx is broad and there is a wide differential diagnosis. The most common presenting symptoms for laryngeal malignancies, both squamous and non-squamous, are hoarseness and dyspnea. Presentation with persistent or worsening symptoms and a submucosal lesion should raise suspicion for a non-squamous malignancy of the larynx. Accurate histology determines the most appropriate treatment and has an impact on prognosis.

Nasal-Type NK/T-Cell Lymphoma Involvement of the Vocal Cord on FDG PET/CT

ABSTRACT

Nasal-type extranodal natural killer/T-cell lymphoma (ENKTL) rarely involves the vocal cord. Herein, we present a case of an ENKTL patient with vocal cord involvement revealed by FDG PET/CT. Nasopharyngoscopy showed a neoplasm in the larynx, which was eventually confirmed as ENKTL by immunohistochemical results. PET/CT was subsequently performed for staging, and intense FDG uptake in the left side of vocal cord suggested ENKTL involvement.

Clinicopathologic characteristics of Burkitt lymphoma of the head and neck in a non-endemic region-a Danish nationwide study

BACKGROUND

Burkitt lymphoma rarely presents in head and neck (H&N) in Western countries.

AIMS/OBJECTIVES

We aimed to characterise clinicopathological features of H&N Burkitt lymphoma in Denmark representing a non-endemic region.

MATERIAL AND METHODS

Clinical records were reviewed for a nationwide cohort of patients diagnosed with H&N Burkitt lymphoma in Denmark between 1980 and 2018. The diagnosis was histologically validated.

RESULTS

Thirty-four patients with H&N Burkitt lymphoma (highest incidence in age group 0-9 years, male-to-female ratio 4.7:1) were included. Thirty-three lymphomas (97%) were extranodal. The tumour was visible at the clinical examination in 81% (n = 22) of the cases. The palatine tonsils were the most frequent location (n = 13, 38%) and 52% (n = 17) of the patients were diagnosed in advanced stage. Lymphoma was the tentative clinical diagnosis in 23% of the cases. The 5-year overall- and disease-specific survival was 78% and 81%, respectively.

CONCLUSIONS

Due to the rarity of Burkitt lymphoma of the H&N, there is a high risk of clinical misdiagnosis. Our findings suggest which symptoms and clinical presentations to be aware of in the diagnostics work up that could lead to the diagnosis of Burkitt lymphoma.

Sporadic Burkitt's Lymphoma of the Hypopharynx: A Case Report

Burkitt's lymphoma is a rapidly growing, high-grade B-cell non-Hodgkin lymphoma that has three distinct variants. Of these, sporadic Burkitt's lymphoma most frequently involves the gastrointestinal system, and the hypopharynx is a rare site of occurrence. Here, the authors report a case of sporadic Burkitt's lymphoma in a 28-year-old male who presented with change of voice as the only complaint. On examination, a mass was found in the hypopharynx that obstructed the laryngeal inlet. The patient underwent an elective examination under general anesthesia and biopsy of the lesion. Histopathological examination confirmed the diagnosis of sporadic Burkitt's lymphoma, following which surgical tracheostomy was performed with complete excision of the mass. A prompt diagnosis is vital to ensure appropriate management of rapidly evolving tumors, such as Burkitt's lymphoma. When diagnosing hypopharyngeal masses, a high index of suspicion is required, as other diseases may appear with similar presentations.

Epidemiology and prognostic indicators in laryngeal lymphoma: A population-based analysis

OBJECTIVES/HYPOTHESIS

To characterize the epidemiology of primary laryngeal lymphoma and to determine the prognostic factors affecting survival in patients with this disease.

STUDY DESIGN

A retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database, including cases from 1973 to 2014.

METHODS

A population-based analysis was conducted with patients from more than 15 different geographic regions across the United States. Patients were chosen based on a diagnosis of lymphoma and a primary lymphoma site within the larynx. Two hundred cases were eligible based on the inclusion criteria, and characteristic as well as clinical variables were then extracted from the database and analyzed. Characteristic and clinical variables included age, race, sex, primary site of lymphoma involvement, general histology, specific histologic subtype, tumor grade, and Ann Arbor staging. Exposure variables that were analyzed included radiation therapy and chemotherapy. Overall survival (OS) and disease-specific survival (DSS) were the main outcomes calculated using multivariate analysis.

RESULTS

A total of 200 cases of laryngeal lymphoma were identified. The mean age at diagnosis was 64.2 years. The cohort was composed of 53% males. B-cell non-Hodgkin's lymphoma (NHL) accounted for 74% of cases, whereas natural killer/T-cell NHL accounted for 10% of cases. A total of 53.1% of patients received radiation therapy, whereas 47.5% received chemotherapy. The median OS was 9.15 years and median DSS was 24.5 years. OS at 2, 5, and 10 years was 74%, 63%, and 44%, respectively. On multivariate analysis, older age, male sex, and advanced Ann Arbor staging were associated with worse OS, whereas only male sex and advanced Ann Arbor staging were associated with worse DSS (all P values < .05). Radiation and chemotherapy were not associated with improved survival.

CONCLUSIONS

Female sex and lower Ann Arbor staging are independent positive prognostic indicators for survival, whereas other clinical variables such as grade and histology do not have an effect on survival. Radiation and chemotherapy do not appear to confer a mortality benefit in patients with primary laryngeal lymphoma, which may have implications on clinical decision making as well as patient education about disease prognosis.

LEVEL OF EVIDENCE

4. Laryngoscope, 128:2044-2049, 2018.