Burkitt lymphoma of the oral cavity: an atypical presentation

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Feb;107(2):240-5. doi: 10.1016/j.tripleo.2008.09.008.

Abstract

Burkitt lymphoma (BL) is an aggressive form of non-Hodgkin B-cell lymphoma with 3 variants: endemic, sporadic, and immunodeficiency-associated types. The sporadic form, most commonly involving the abdomen and ileocecal region, presents as an abdominal mass, rarely presenting in the orofacial region. A 36-year-old Indian female presented to the Hospital of the University of Pennsylvania for evaluation of a persistent intraoral swelling ulceration of the lower right mandibular alveolar ridge with minimal bony invasion. Progressive systemic symptoms of fatigue, weakness, and fever developed without resolution following treatment for a presumed odontogenic infection in the 4 weeks before presentation. An incisional biopsy revealed a diffuse proliferation of intermediate- to large-sized lymphocytes with multiple small peripheral nucleoli, scant cytoplasm, and nuclear pleomorphism. Nearly all cells displayed Ki67 expression. A final diagnosis of BL was rendered following confirmation of a cMYC translocation by fluorescence in situ hybridization. This article presents a case of the sporadic form of BL with atypical presentation clinically and morphologically, primarily involving the oral soft tissue.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Burkitt Lymphoma / drug therapy
  • Burkitt Lymphoma / genetics
  • Burkitt Lymphoma / pathology*
  • Cyclophosphamide / administration & dosage
  • Dexamethasone / administration & dosage
  • Diagnosis, Differential
  • Doxorubicin / administration & dosage
  • Female
  • Gingival Neoplasms / drug therapy
  • Gingival Neoplasms / genetics
  • Gingival Neoplasms / pathology*
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Humans
  • Infusions, Intralesional
  • Mandibular Neoplasms / drug therapy
  • Mandibular Neoplasms / genetics
  • Mandibular Neoplasms / pathology*
  • Proto-Oncogene Proteins c-myc / genetics
  • Translocation, Genetic
  • Vincristine / administration & dosage

Substances

  • MYC protein, human
  • Proto-Oncogene Proteins c-myc
  • Granulocyte Colony-Stimulating Factor
  • Vincristine
  • Dexamethasone
  • Doxorubicin
  • Cyclophosphamide

Supplementary concepts

  • CVAD protocol