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Navigating Rare Presentations: Recurrent Burkitt Lymphoma Presenting as a Jejunal Mass
Tejas Nikumbh1, Archit Garg2, Himani Mongia1
1The Wright Center for Graduate Medical Education Scranton Pennsylvania United States.
None:
Burkitt lymphoma (BL) is an aggressive B-cell malignancy characterized by rapid progression and MYC gene translocations. Jejunal involvement in BL is rare compared to more common sites like the lymph nodes and central nervous system. Diagnosing BL in the jejunum is particularly challenging as it can mimic other gastrointestinal conditions, necessitating a high index of suspicion and histopathological confirmation. We present the case of a 37-year-old male with a history of stage III non-seminomatous testicular carcinoma, BL, deep venous thrombosis, pulmonary embolism, and hypogammaglobulinemia, who presented with abdominal pain and nausea. Imaging revealed peritoneal carcinomatosis and a left hemiabdomen mass concerning malignancy. Given his medical history of previously diagnosed BL in the gastrohepatic ligament lymph node and imaging findings, BL relapse was suspected. Push enteroscopy with biopsy confirmed the recurrence of BL in the jejunum, with positive markers for CD45, CD20, BCL6, and c-Myc. Despite aggressive supportive care, the patient succumbed to his disease. This case highlights the importance of early recognition of BL, particularly in rare extra-nodal sites like the jejunum. Further research is needed to improve early detection and treatment outcomes for patients with relapsed or refractory BL.
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