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[Paediatric Burkitt lymphoma presenting as acute pancreatitis]
Filipe Glória Silva1, Mafalda Paiva, Ana Tavares
1Unidade de Cuidados Intensivos Pediátricos, Hospital de Dona Estefânia, Lisbon.
Insights
Pediatric acute pancreatitis is rare, especially when caused by tumors. This case highlights Burkitt Lymphoma as an unusual cause of pancreatitis and cholestasis in a 13-year-old boy, successfully treated with chemotherapy.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Oncology
- Hematology
Background:
- Pancreatitis in children and adolescents is uncommon, with diverse etiologies differing from adults.
- Tumoral causes of pancreatitis in pediatric patients are exceptionally rare.
Observation:
- A 13-year-old boy presented with acute pancreatitis, pleural effusion, and ascites.
- Imaging suggested an infiltrative gastric wall process; endoscopy revealed a gastric and duodenal tumor with a large ulcer.
- Biopsies confirmed Burkitt Lymphoma, further supported by ascitic fluid analysis.
Findings:
- The patient was diagnosed with stage III Burkitt Lymphoma.
- Treatment involved chemotherapy according to the FAB LMB 96 protocol.
- Complete remission was achieved following treatment.
Implications:
- This case underscores that acute pancreatitis and cholestasis can be rare presenting symptoms of lymphoma in pediatric patients.
- Highlights the importance of considering rare etiologies in pediatric pancreatitis.
- Demonstrates successful management of a rare presentation of pediatric Burkitt Lymphoma.
Abstract:
Pancreatitis in children and adolescents is uncommon and its causes are more varied in this age group than in adults. A tumoral aetiology is particularly rare. We present the case of a 13-year-old boy who was admitted to our Intensive Care Unit with the diagnosis of acute pancreatitis, bilateral pleural effusion and ascites. Serial sonographic and computed tomography evaluations were suggestive of an infiltrative process of the gastric wall. Endoscopy showed an infiltrative tumor of the gastric mucosa and duodenum with a giant ulcer. Biopsies were compatible with Burkitt Lymphoma confirmed by ascitic fluid cytology and cytometry. Because of severe progressive cholestasis a temporary biliary stent was placed in the common bile duct. After staging (stage III), the patient was treated according to FAB LMB 96 chemotherapy protocol, achieving complete remission. Acute pancreatitis and cholestasis are rare presentations of lymphoma in the paediatric age group.
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