Burkitt Leukemia Presenting as Acute Appendicitis: A Case Report and Literature Review

Acute abdominal pain as the initial presenting symptom of pediatric Burkitt lymphoma: A case report and literature review

RATIONALE

Acute abdominal pain is a prevalent clinical symptom in pediatric patients, primarily attributed to pediatric acute abdomen. However, there are rare exceptional instances where neoplastic diseases may cause acute abdominal pain.

PATIENT CONCERNS

The present study encompasses a case of pediatric Burkitt lymphoma wherein acute abdominal pain manifested as the initial symptom, erroneously diagnosed as acute appendicitis.

DIAGNOSES

The immunohistochemistry results of laparoscopic biopsy revealed Burkitt lymphoma, characterized by positive expression of CD20, CD79a, CD10, BCL-6, MUM1, and strong positive expression of CD38, c-myc, cyclinD1, and Ki-67 positive index >90%+.

INTERVENTIONS

The child underwent regular chemotherapy according to the SCCCG-BL/DLBCL-2017 regimen.

OUTCOMES

During the 13-month follow-up period, the patient's obtained complete remission by Positron emission tomography-computed tomography scan.

LESSONS

The objective of this study is to enhance the awareness of clinical pediatricians regarding cases of acute abdominal pain caused by lymphoma.

Burkitt lymphoma presenting as cecum mass and spontaneous tumor lysis syndrome with hypercalcemia

Burkitt's lymphoma (BL) could be primarily presented with various symptoms. We reported a woman with abdominal pain and mass who later developed spontaneous TLS with hypercalcemia, and was diagnosed with BL. Clinicians should suspect BL in case of any abdominal mass, especially with an aggressive course, to avoid further complications.

Double-Expressor Appendiceal Burkitt’s Lymphoma: A Case Report and Literature Review

Background

Appendiceal lymphoma is a very rare entity accounting for 0.015% of all gastrointestinal lymphoma cases. Acute appendicitis is the most common presentation of primary appendix neoplasms. Burkitt's lymphoma presenting as an acute appendicitis is a rare entity with around 21% of the cases presenting as a lower iliac fossa mass. Case Presentation. A 23-year-old male was admitted to the surgical ward as a case of acute appendicitis with localized tenderness in the right iliac fossa, positive rebound tenderness, a positive Rovsing's sign, and ultrasound findings of suspected complicated appendicitis. Appendectomy was performed. Histopathological examination of the appendectomy specimen revealed a double-expressor non-Hodgkin diffuse large cell lymphoma with Burkitt's-like morphology. He was sent for chemotherapy treatment.

Conclusion

Only 34 cases of Burkitt's lymphoma have been reported to present as acute appendicitis. Histological examination following appendectomy for an apparent appendicitis is essential. Furthermore, complete blood count and a computed tomography scan aid the diagnosis of lymphoma. Double-expressor lymphoma has been shown to have poor outcomes. Therefore, prompt and aggressive treatment is vital.

Burkitt Lymphoma Presenting as Perforated Appendicitis

Appendicitis is the most common indication for an emergent abdominal operation in the pediatric population. Fewer than .015% of patients who undergo appendectomy for presumed appendicitis are diagnosed with primary lymphoma after evaluation of pathology specimen. 1 Of these primary lymphomas, 29.5% are Burkitt lymphoma. Burkitt lymphoma is an aggressive B-cell lymphoma characterized by translocation and dysregulation of the c-Myc gene. Intraabdominal extranodal Burkitt lymphoma has a polymorphic presentation that includes bowel obstruction, intussusception, and appendicitis. Here we report a case of an adolescent patient who was initially admitted for medical management of perforated appendicitis but was diagnosed with Burkitt lymphoma during his hospital course.