A rare cause of gastric malignancy: Burkitt’s lymphoma

Abstract

A 33-year-old man presented with a 1-week history of nausea, vomiting, and abdominal distension. Initial laboratory tests were significant for white blood cell count (12 × 10 9 /L), creatinine (1.4 mg/dL), and lactic acid dehydrogenase (2014 U/L). Computed tomography scan showed severe thickening of the gastric body, ascites, and peritoneal induration (• " Fig. 1 a). Based on these findings the patient underwent esophagogastroduodenoscopy, which revealed diffusely ulcerated mucosa involving the majority of the gastric body (• " Fig. 1 b). Endoscopic ultrasound (EUS) demonstrated gastric wall thickening of up to 50 mm (• " Fig. 1 c). Mucosal biopsies and fine-needle aspiration (FNA) of the gastric wall were performed. Epstein-Barr virus and HIV serology were negative, whereas Helicobacter pylori serology was positive. Flow cytometry and cytologic examination of the FNA specimen demonstrated monotonous atypical CD10-positive B-cells with immunohistochemical stains positive for BCL-6 and C-MYC (• " Fig. 1 df) consistent with a diagnosis of Burkitt's lymphoma. Chemotherapy was initiated with the R-CHOP regimen as well as H. pylori eradication therapy. Burkitt's lymphoma is a rare cause of B-cell non-Hodgkin lymphoma with an aggressive clinical course. Its sporadic

Primary gastric Burkitt’s Lymphoma mimicking gastric cancer: a case report

“…Primary BL of stomach is rare. Primary gastric BL in adults has been reported by Mitra S, Khan A, Doycheva I et.al (2,9,11,12). Their study showed that the ratio of male patients is higher than female.…”

“…These two types usually affect extranodal sites (such as bone marrow and GI-tract) and CNS (especially the pia mater) (20,21). According to previous case reports, most patients with gastric BL have mild symptoms even though lesions of the stomach are serious (11,13,14). But the disease can progress very quickly and some serious symptoms appear, such as gastrointestinal bleeding and di culty swallowing.…”

“…Gastrointestinal endoscopy can intuitively show mass in GI-trcat and it can assess tumor in ltration well. Under endoscopy, gastric Burkitt's lymphoma is common in ulcerative lesions (2,9,11,13,14). And the ulcer surface is often covered with a large amount of mucus.…”

Burkitt’s Lymphoma of the Rectosigmoid and Stomach Presenting as Hematochezia

“…Endoscopy is important to establish the diagnosis of GI BL by taking biopsies of the affected area and to define tumor extension and infiltration. Although there are no pathognomonic lesions, several endoscopic signs have been associated with BL in the stomach (submucosal nodules [ 13 ], single or multiple tumors with or without ulceration [ 14 ], diffuse ulceration of the stomach [ 15 ], and thickening of gastric folds [ 16 ]) and colon (polypoid masses [ 7 ] and partially obstructive heterogeneous non-ulcerated masses [ 5 ]). As there is no definitive test that establishes the diagnosis of BL, it is important to recognize that GI endoscopy is one of many tools used in combination with other imaging and histopathologic techniques to increase the diagnostic accuracy of this rare malignancy [ 17 ].…”