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A case of Burkitt Lymphoma discovered by digital rectal exam

Colin Winke1, Brandon Moore1, Jacob Gelman1

  • 1Department of Pediatrics, Division of Pediatric Gastroenterology and Hepatology West Virginia University School of Medicine Morgantown West Virginia USA.

JPGN Reports
|August 16, 2024
PubMed

Insights

A pediatric case of Burkitt Lymphoma (BL) presented with vague gastrointestinal symptoms. A digital rectal exam (DRE) was crucial in diagnosing this aggressive B-cell lymphoma, leading to successful treatment.

Area of Science:

  • Pediatric Oncology
  • Gastroenterology
  • Diagnostic Imaging

Background:

  • Burkitt Lymphoma (BL) is an aggressive B-cell malignancy primarily affecting children.
  • Sporadic BL often presents with abdominal or pelvic involvement.
  • Nonspecific gastrointestinal symptoms can obscure the diagnosis in pediatric patients.

Observation:

  • An 8-year-old male presented with vomiting, weight loss, fatigue, and abdominal pain.
  • Initial abdominal X-ray was unremarkable.
  • A digital rectal exam (DRE) revealed a palpable rectal lesion.

Findings:

  • Advanced imaging (MRI, CT) identified a left lower quadrant lesion with extension to the porta hepatis and encasing the left distal ureter.
  • Histopathological analysis of a biopsy confirmed Burkitt Lymphoma.
  • The patient achieved remission after completing chemotherapy.

Implications:

  • This case underscores the importance of DRE as a fundamental diagnostic tool in evaluating pediatric patients with nonspecific gastrointestinal complaints.
  • Early detection through thorough physical examination can lead to timely diagnosis and treatment of aggressive pediatric lymphomas.
  • Integrating basic physical exam skills with advanced imaging is vital for comprehensive pediatric cancer diagnosis.

Keywords:
colonoscopygastroenterologyphysical examinationvomitingweight loss

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