Pediatric pancreatic Burkitt lymphoma with obstructive jaundice: case report of a six-year-old child

Abstract

Introduction: Burkitt lymphoma represents about 50% of non-Hodgkin lymphomas and 3% of cancers in children. It commonly affects the abdomen; however, pancreatitis is a very rare initial presentation. Less than 10 cases with this presentation are reported in the literature. Observation: We report the case of a six-year-old girl who presented a rapidly progressing obstructive jaundice evolving for a week. The LDH rate was not increased. Medical imaging has shown a global increase in the size of the pancreas, homogeneous hepatomegaly with dilatation of the gallbladder and the intra-hepatic bile ducts, and infiltration of the left ovary, without ascites. The patient was diagnosed with pancreatic Burkitt Lymphoma after an endoscopic exploration and tumor biopsy. Conclusion: While extremely rare, Burkitt lymphoma should be evoked in the case of pancreatitis with a global increase of the pancreas size, associated with other intra-abdominal organ infiltration in the pediatric population.

Could the burden of pancreatic cancer originate in childhood?

“…The literature reports less than 10 cases of pancreatic lymphoma manifesting as acute pancreatitis at debut. Athmani et al [ 28 ] report the case of a 6-year-old female with a rapidly progressive jaundice; in that case, abdominal imaging showed an important increase in the pancreatic size, homogeneous hepatomegaly and intra- and extrahepatic biliary ducts’ dilatation. Ultimately, the histopathological examination set the diagnosis of Burkitt’s lymphoma.…”

Sporadic Burkitt Lymphoma Presenting with Middle Cranial Fossa Masses with Sphenoid Bony Invasion and Acute Pancreatitis in a Child

“…In a recent case report and literature review by Lee et al on BL presenting as acute pancreatitis, a total of 15 cases were identified [2,[10][11][12][13][14][15][16][17][18][19][20][21]. Twelve of the 15 cases were children [2,[10][11][12][13][14][15][16][17][18], 5/15 presented with jaundice [2,10,11,15,17], and 10/15 had diffuse pancreatic enlargement [2, 10, 11, 13-18, 20, 21].…”

“…In a recent case report and literature review by Lee et al on BL presenting as acute pancreatitis, a total of 15 cases were identified [2,[10][11][12][13][14][15][16][17][18][19][20][21]. Twelve of the 15 cases were children [2,[10][11][12][13][14][15][16][17][18], 5/15 presented with jaundice [2,10,11,15,17], and 10/15 had diffuse pancreatic enlargement [2, 10, 11, 13-18, 20, 21]. Only 1/12 reported CBD dilation up to 9 mm on MRI, significantly less than the 26 mm dilation seen in our patient on MRCP [2].…”

Linfoma De Burkitt Como Causa De Pancreatite Aguda: Revisão Bibliográfica

“…O Vírus da Imunodeficiência Humana (HIV), particularmente, propicia patógenos de infecções oportunistas, incluindo o Vírus Epstein-Barr (EBV) (BACCHI et al, 1996).…”

“…No Brasil, onde há alta incidência de co-infecção HIV e EBV, um estudo encontrou relação de 55% entre a presença de EBV e o desenvolvimento de LNHs nos pacientes com SIDA (LIMA et al, 2006). Do total de casos, 25% foram caracterizados como células pequenas não clivadas, do tipo Burkitt (BACCHI et al, 1996).…”