scholarly journals A CASE OF ILEOILEAL INTUSSUSCEPTIONS CAUSED BY BURKITT’S LYMPHOMA

2016 ◽  
Vol 7 (1) ◽  
Author(s):  
F. Molinaro ◽  
E. Bindi ◽  
M. Sica ◽  
F. Mariscoli ◽  
R. Angotti ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Histological Examination ◽  
Surgical Intervention ◽  
Burkitt’S Lymphoma ◽  
Burkitt's Lymphoma ◽  
World Health ◽  
Disease Stage ◽  
Metabolic Complications ◽  
Intestinal Occlusion ◽  
Stage Disease

<strong>Introduction</strong> Burkitt’s lymphoma is a high grade B-cell tumor described for the first time by the Irish surgeon Dennis Burkitt in 1958 in Africa. The most frequent of the clinical variants, in which it is classified by the World Health Organization (sporadic, endemic, HIV-associated), is the sporadic one, which usually involves the abdomen, in particular the ileocecal tract. Thus, a common clinical presentation is that of a child suffering from abdominal pain with nausea and vomit, until the dramatic case of an intestinal occlusion by an intussusceptions. According to this, the surgeon is the first who diagnoses and treats this tumor, playing an important role for the treatment, in terms of reduction of the metabolic complications of the medical therapy and of improvement of survival rate. In this work we present a case of a child operated for intestinal occlusion by ileoileal intussusception, caused by a Burkitt’s lymphoma, as it was diagnosed by histological examination few days after surgical intervention. <br /><strong>Case report</strong> A 12-years boy reached the emergency department for abdominal pain and vomit. Two weeks before he had a surgical intervention for a suspected appendicitis at another hospital. An ultrasound examination was performed and it revealed the presence of a complex mass in the right iliac fossa. The day after the patient felt worse and he had an episode of bilious vomit. An x-ray examination of the abdomen was performed and showed the presence of an intestinal obstruction. The patient underwent to surgical intervention. The obstruction was caused by an ileoileal intussusceptions, and it needed to perform a resection followed by anastomosis. Few day after surgical intervention, the result of histological examination indicated the presence of a Burkitt’s lymphoma within the tract resected. A CT scan was performed and showed the involvement of mesenteric lymph nodes. The bone marrow aspirate and the lumbar puncture showed no neoplastic presence. Then the patient started therapy according to protocol. <br /><strong>Discussion and Conclusions</strong> Burkitt’s lymphoma represents 3-5% of all non-Hodgkin lymphomas, and 40% in pediatric population. Children have an excellent prognosis with contemporary treatment regardless of the disease stage. Patients with limited stage disease are curable with limited treatment, avoiding complications associated with more intensive therapies. Nevertheless surgery is important in the management of this disease, the role of the surgeon has usually been controversial. A surgical intervention can be resolving in case of limited disease, or, in case of a high stage disease, it can be diagnostic or helpful, through the debulking of the mass. However, apart in case of intussusception, the diagnoses of Burkitt can be challenging and the presence of disease can revealed after a story of recurrent abdominal pain or after surgical interventions for appendicitis. In this work we show how a timely diagnosis can be difficult and how it can be an obstacle for treatment. In this case the sudden worsening of clinical conditions permitted an early diagnosis with a complete resection of the ileum involved by Burkitt’s lymphoma has improved the prognosis and reduced therapy’s complications.

Small noncleaved cell lymphoma in adults: superior results for stages I-III disease.

1990 ◽  
Vol 8 (4) ◽  
pp. 615-622 ◽  
Author(s):  
T M Lopez ◽  
F B Hagemeister ◽  
P McLaughlin ◽  
W S Velasquez ◽  
F Swan ◽  
...  
Keyword(s):  
Cell Lymphoma ◽  
Stage Iv ◽  
Complete Response ◽  
Burkitt’S Lymphoma ◽  
Response To Therapy ◽  
Burkitt's Lymphoma ◽  
Disease Stage ◽  
Histologic Subtype ◽  
Ann Arbor ◽  
Stage Iv Disease

Small noncleaved cell lymphoma (SNCCL), a rare lymphoma in adults, is associated with not only a rapid complete response (CR) to chemotherapy but also with the potential to rapidly relapse both systemically and in the CNS. We treated 44 assessable adults with two similar protocols, consisting of three sequential chemotherapy combinations and intrathecal prophylaxis with methotrexate and cytarabine. The overall CR rate was 80%; it was 100% in patients with Ann Arbor (AA) stages I-III disease and 57% in those with stage IV disease. The overall survival (OS) rate at 5 years was 52%. The overall 5-year freedom from tumor mortality (FTM) rate was 63%; it was 95% for patients with AA stages I-III disease, and 29% for those with stage IV disease. Stepwise multivariate analysis of factors associated with remission duration and survival indicated that advanced-disease stage and age of 40 years or over were predictors of poor prognosis. Twelve patients with positive human immunodeficiency virus (HIV) serology were also included in this series. They had an 83% CR rate and an 83% 5-year FTM, but only a 36% 5-year OS; most deaths were secondary to opportunistic infection. Histologic subtype (Burkitt's lymphoma [BL] or non-Burkitt's lymphoma [NBL]) did not correlate with patient age, site of tumor presentation, response to therapy, or survival. Both protocols achieved comparable results. The approach used in these protocols is highly effective for patients with early staged disease, regardless of their HIV status; however, better therapy is necessary for those with SNCCL presenting in an advanced stage.

scholarly journals Is R-CODOX-M/IVAC Inferior to Other Regimens in Burkitt’s Lymphoma: A Single Center Experience

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5448-5448
Author(s):  
Erden Atilla ◽  
Ugur Sahin ◽  
Pinar Ataca ◽  
Atilla Uslu ◽  
Ekin Kircali ◽  
...  
Keyword(s):  
Overall Survival ◽  
Burkitt’S Lymphoma ◽  
Burkitt's Lymphoma ◽  
Disease Stage ◽  
Rank Test ◽  
Published Data ◽  
High Dose ◽  
Disease Characteristics ◽  
Log Rank Test ◽  
Lymphoma Risk

Abstract INTRODUCTION: Though widely used and accepted as a first line regimen, published data regarding R-CODOX-M/IVAC is very limited. Up to date only three prospective studies and one case series have been reported. Herein, we present our institution’s experience with the management of Burkitt’s lymphoma with a special emphasis on the R-CODOX-M/IVAC regimen. METHODS: The files and electronic records of 35 patients diagnosed with Burkitt’s lymphoma between January 2005 and June 2014 were retrospectively revised. RESULTS: The median age at diagnosis was 40 (21-86 years). Male patients constituted 71.4 (n=25). Stage IV disease was present in 60.6% (n=20), and stage I disease in 27.3% (n=9) of the patients. ECOG performance scoring was < 3 in 70.6% (n=24) and Burkitt’s lymphoma risk scoring (availability of complete surgical resection, stage, serum LDH and CNS involvement) > 2 in 58.6% (n=17). The distribution of patients to administered regimens were as follows: R-CODOX-M/IVAC 10 patients (28.6%), HyperCVAD 5 patients (14.3%), R-CHOP 9 patients (25.7%), R-CVP 2 patients (5.7%), CALGB 10002 1 patient (2.9%) and other regimens (high dose methotrexate, high dose cytarabine, vincristine-prednisolone, etc.) 8 patients (23.0%). Median overall survival (OS) was 23.5 (1-114) months and median progression free survival was 17.0 (0-114) months. Relapses occurred in 7 patients (20.0%), mortality in 12 patients (34.3). R-CODOX-M/IVAC group (n=10) was compared to other rituximab containing regimens (R-CHOP, R-CVP) (n=11) and HyperCVAD (n=5) and other rituximab-free regimens (n=9) with respect to patient and disease characteristics, DFS and OS. The disease stage, ECOG performance score and Burkitt’s lymphoma risk score were similar between the four groups (p=0.6, p=0.2 and p=0.2, respectively). However, median OS was 13 (1-42) months in R-CODOX-M/IVAC group and it was significantly lower than other regimens (p=0.04 log rank test). Median PFS was 13 (0-42) months and also lower compared to other regimens, however, the difference was not statistically significant (p=0,1 log rank test). CONCLUSIONS: Burkitt’s lymphoma is currently one of the most aggressive mature B- cell origin lymphomas and there is no consensus on the standard of care. CODOX-M/ IVAC is one of the most frequently used regimen. Adding rituximab is also known to prolong overall survival in this patient population. Though the sample sizes are too small and the drawbacks of the retrospective study design exist, the inferior OS and PFS observed in this study with R-CODOX-M within patients having similar disease characteristics should be taken into account. Further studies comparing the efficiency of currently used regimens are needed to reach a clear conclusion. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures No relevant conflicts of interest to declare.

Primary Burkitt's Lymphoma of the Colon –An Uncommon Cause of Acute Constipation and Abdominal Pain

2012 ◽  
Vol 31 (4) ◽  
pp. 254-259 ◽  
Author(s):  
Caroline T. Meyer ◽  
Michael J. Wilsey ◽  
Gregory A. Hale ◽  
Hector L. Monforte ◽  
Paul D. Danielson
Keyword(s):  
Abdominal Pain ◽  
Burkitt’S Lymphoma ◽  
Burkitt's Lymphoma

Burkitt's lymphoma of the tonsil

1990 ◽  
Vol 104 (12) ◽  
pp. 991-994 ◽  
Author(s):  
Mordechai Kraus ◽  
Dan M. Fliss ◽  
Shmuel Argov ◽  
Alberto Leiberman ◽  
Daniel Benharroch
Keyword(s):  
Electron Microscopy ◽  
Histological Examination ◽  
English Language ◽  
Clinical Presentation ◽  
Burkitt’S Lymphoma ◽  
Burkitt's Lymphoma ◽  
Biological Behaviour ◽  
English Language Literature ◽  
Language Literature

AbstractA case of Burkitt's lymphoma involving the tonsil in a 10-year-old Bedouin boy, is presented. The biological behaviour and the clinical presentation of this unusual neoplasm are discussed and the English language literature is reviewed.The diagnosis was made by histological examination, electron microscopy and confirmed by immunohistochemistry. The patient showed an excellent symptomatic response to surgery and chemotherapy.

Burkitt’s Lymphoma Presenting as Abdominal Pain in a Young, Healthy Woman

2014 ◽  
Vol 109 ◽  
pp. S411
Author(s):  
Jason Rubinov ◽  
Isabel Preeshagul ◽  
Andrew Korman ◽  
David Carr-Locke ◽  
Nancy Lau
Keyword(s):  
Abdominal Pain ◽  
Healthy Woman ◽  
Burkitt’S Lymphoma ◽  
Burkitt's Lymphoma

Diffuse small noncleaved-cell, non-Burkitt's lymphoma in adults: a high-grade lymphoma responsive to ProMACE-based combination chemotherapy.

1994 ◽  
Vol 12 (10) ◽  
pp. 2153-2159 ◽  
Author(s):  
D L Longo ◽  
P L Duffey ◽  
E S Jaffe ◽  
M Raffeld ◽  
S M Hubbard ◽  
...  
Keyword(s):  
Overall Survival ◽  
Combination Chemotherapy ◽  
Survival Rates ◽  
Large Cell ◽  
Complete Response ◽  
Burkitt’S Lymphoma ◽  
Burkitt's Lymphoma ◽  
Advanced Stage ◽  
Stage Disease ◽  
Localized Disease

PURPOSE To review the efficacy of cyclophosphamide, doxorubicin, etoposide, methotrexate with leucovorin, and prednisone (ProMACE)-based combination chemotherapy programs in the treatment of patients with diffuse small noncleaved-cell non-Burkitt's lymphoma. PATIENTS AND METHODS Thirty-three patients with diffuse small noncleaved-cell non-Burkitt's lymphoma were accrued: eight with localized disease were treated with modified ProMACE-mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) plus involved-field radiation therapy, and 25 with advanced-stage disease were treated with ProMACE/MOPP flexitherapy (n = 8), ProMACE-MOPP (n = 9), or ProMACE-cytarabine, bleomycin, vincristine, and methotrexate with leucovorin (CytaBOM) (n = 8). The median follow-up duration is 10 years. RESULTS All eight patients with localized disease achieved a complete response, none have relapsed, and one died of intercurrent illness. Among patients with advanced-stage disease, five of eight (63%) flexitherapy-treated patients, six of nine (67%) ProMACE-MOPP-treated patients, and eight of eight (100%) ProMACE-CytaBOM-treated patients achieved a complete response. If the two ProMACE-MOPP-based groups are considered together, disease-free and overall survival rates at 15 years are projected at 61% and 35%, respectively. In contrast, only one patient has relapsed from a ProMACE-CytaBOM-induced complete remission, and overall survival of ProMACE-CytaBOM-treated patients (88%) is significantly higher than that for flexitherapy and ProMACE-MOPP (P2 = .04). CONCLUSION Adult patients with diffuse small non-cleaved-cell non-Burkitt's lymphoma may be effectively treated with regimens that are effective in other aggressive lymphomas (eg, diffuse large-cell lymphoma).

scholarly journals An Exceptional Case of Ileocolic Intussusception Secondary to Burkitt’s Lymphoma: What Variations Are There in the Presentation and Management of Those Patients Who Approach Adolescence?

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Krish Kulendran ◽  
Kay Tai Choy ◽  
Cian Keogh ◽  
Dinesh Ratnapala
Keyword(s):  
Abdominal Pain ◽  
Case Reports ◽  
Paediatric Population ◽  
Burkitt’S Lymphoma ◽  
Exceptional Case ◽  
Burkitt's Lymphoma ◽  
Lead Point ◽  
Ileocolic Intussusception ◽  
Diagnostic Dilemma ◽  
Pathological Lead Point

Intussusception is a common cause of abdominal pain among the paediatric population with up to 10% of cases occurring secondary to a pathological lead point. Burkitt’s lymphoma (BL) is a highly malignant and rapidly growing B-cell neoplasm which in extremely rare cases can present as intussusception. We report a case in an otherwise healthy 15-year-old male who presented with atypical abdominal pain. Imaging subsequently indicated an ileocolic intussusception, and given that the suspicion of a pathological lead point mandates a laparotomy and bowel resection, he proceeded to surgery. The histopathology confirmed Burkitt’s lymphoma as the aetiology responsible for this intussuscepted mass. A detailed discussion including a systematic review of all previous case reports explore the diagnostic dilemma of intussusceptions secondary to BL. This case report aims to highlight the clinical challenges in establishing such a diagnosis and an appreciation for the subtle variations in clinical features, as well as the differences in management between infants and adolescents.

Curability of Burkitt's lymphoma with high-dose cyclophosphamide-high-dose methotrexate therapy and intrathecal chemoprophylaxis.

1985 ◽  
Vol 3 (5) ◽  
pp. 627-636 ◽  
Author(s):  
M P Sullivan ◽  
I Ramirez
Keyword(s):  
Side Effects ◽  
Complete Remission ◽  
Burkitt’S Lymphoma ◽  
Burkitt's Lymphoma ◽  
Disease Stage ◽  
Infusion Therapy ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
High Doses

Twenty-four children with Burkitt's lymphoma were treated beginning May 1976 with a regimen alternating high doses of cyclophosphamide and methotrexate in induction and consolidation; only high doses of methotrexate were used in the maintenance phase. Throughout therapy, which was planned for 54 weeks, intrathecal chemoprophylaxis using methotrexate, cytosine arabinoside, and hydrocortisone was coordinated with the high-dose methotrexate infusion therapy to provide CNS chemoprophylaxis that maintained therapeutic methotrexate spinal fluid levels (greater than 10(-6) mol/L) for approximately 60 hours. Twenty-two (92%) of the 24 children attained complete remission; two (8.3%) patients attained only partial remission, failing therapy. Two children died of infection while in complete remission; two children relapsed on therapy. Actual survival is 75%; the median follow-up time is 38+ months (range, 1 1/2+ to 84+ months). Relapses correlated with Murphy disease stage as follows: stage I--0/3, stage II--2/7, stage III--2/10, and stage IV--0/2. Serious side effects and toxicities of chemotherapy occurred in ten patients (metabolic disturbances after rapid tumor lysis, two; infectious and/or febrile episodes following cyclophosphamide therapy, three; methotrexate side effects, four; and complications of intrathecal therapy, one). Results of this therapy are similar to those of the best regimens that have been reported. Treatment has been adapted for use in Burkitt's lymphoma by the Pediatric Oncology Group; the responsiveness of other B cell lymphomas of childhood to this treatment is also being determined.

scholarly journals MYC Negative Rectal B-Cell Lymphoma, Unclassifiable, with Features Intermediate between Diffuse Large B-Cell Lymphoma and Burkitt’s Lymphoma in an Immunocompetent Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Jignesh G. Parikh ◽  
Ted Strom ◽  
Ilya Stone
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Burkitt’S Lymphoma ◽  
Immunocompetent Patient ◽  
Burkitt's Lymphoma ◽  
World Health ◽  
Grey Zone ◽  
Large B Cell Lymphoma ◽  
Large B Cell

B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma (BLUI) is a recently added entity to the World Health Organization (WHO) classification to address a grey zone between large B-cell lymphoma (DLBCL) and Burkitt’s lymphoma (BL). These are rare aggressive lymphomas, which were previously also known as Burkitt’s-like lymphoma (BLL). BL and BLUI/BLL of the colon mostly involve the ileocecal region. In the rectum, BL and BLUI/BLL almost always affect patients with the acquired immune deficiency syndrome (AIDS). We report the first case of rectal BLUI/BLL in an immunocompetent patient who is also negative for MYC abnormalities and the EBV early RNA (EBER) in situ hybridization.

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