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Burkitt's lymphoma presenting as acute appendicitis: a case report
Sebastião D de Morais1, Bruno M Mikhael2, Stephanie I A Németh2
1HRAN (Hospital Regional da Asa Norte), Departmant of Surgery, Brasília 70710-910, Brazil.
Journal of Surgical Case Reports
|June 27, 2018
Summary
Appendiceal lymphoma is rare, with Burkitt's lymphoma being the second most common type. This case highlights a young man initially diagnosed with appendicitis who later presented with advanced Burkitt's lymphoma, successfully treated with chemotherapy.
Area of Science:
- Gastrointestinal Oncology
- Hematology
- Surgical Pathology
Background:
- Appendiceal lymphomas are extremely rare, accounting for approximately 0.015% of all gastrointestinal lymphomas.
- Burkitt's lymphoma represents the second most frequent histological subtype, diagnosed in 25.9% of appendiceal lymphoma cases.
Observation:
- A 36-year-old male presented with acute right lower quadrant abdominal pain, initially diagnosed as acute appendicitis.
- Post-appendectomy, the patient developed severe back pain, abdominal swelling, night sweats, fevers, and weight loss.
- Histopathological examination of the appendix revealed diffuse, transmural lymphoid proliferation consistent with high-grade B-cell lymphoma.
Findings:
- Immunohistochemistry confirmed the diagnosis as Burkitt's lymphoma.
- The patient was staged as IVxB lymphoma.
- Treatment with polychemotherapy resulted in a complete clinical response within 8 months.
Implications:
- This case underscores the importance of considering rare differentials like Burkitt's lymphoma in patients presenting with seemingly typical appendicitis symptoms.
- Early recognition and appropriate staging are crucial for effective management of appendiceal lymphomas.
- Successful treatment with polychemotherapy demonstrates the efficacy of systemic therapy for advanced-stage appendiceal Burkitt's lymphoma.