Simultaneous Maxillofacial, Abdominal, and Bone Marrow Involvement in a Pediatric Patient With Epstein-Barr...

Burkitt lymphoma is a rare and aggressive B-cell origin non-Hodgkin lymphoma, which has been classified as a poorly differentiated lymphocytic lymphoma. Three major subtypes of Burkitt lymphoma have been identified, namely endemic, sporadic, and immunodeficiency-associated. While an abdominal (ileocecal) mass is the most common presentation of Burkitt lymphoma in sporadic populations, including the Indian subcontinent, involvement of the face/jaw/sinuses/ovaries is considered to be extremely rare. We present the case of a three-year-old female child who presented with progressive, painless, bilateral cheek swelling with facial and periorbital puffiness and abdominal distension, which was associated with a high-grade fever and significant weight loss for 20 days. The simultaneous involvement of solid organs of the abdomen and face is a very rare presentation in the Indian population. Diagnosis was confirmed by fine needle aspiration cytology (FNAC) of cervical lymph nodes and immunohistochemistry (IHC) of bone marrow biopsy. The patient was diagnosed with Stage 4 Burkitt lymphoma. Extra-abdominal involvement at presentation, particularly of the facial bones or sinuses, is uncommon in the Indian setting. This highlights the variety of Burkitt clinical presentations in India and the significance of early diagnosis.