Intussusceptions as acute abdomen caused by Burkitt lymphoma: a case report

Abstract

Introduction: Burkitt's lymphoma is a highly malignant, aggressive and rapidly growing B-cell neoplasm, which has low long-term survival rates. The abdomen is the most frequent onset site of non endemic Burkitt's lymphoma. Symptoms are often misleading and make diagnosis difficult. Ileum intussusception as acute abdomen caused by Burkitt lymphoma is rare.

Case presentation: We are presenting a case of a 16 year-old male with acute abdomen, which three weeks prior initially has been surgically treated for acute appendicitis and Meckel diverticulitis. Following this was a second urgent operation of ileoileal intusussception caused by Burkitt lymphoma. Right extended haemicolectomy was performed.

Conclusion: Affected terminal ileum by Burkitt's lymphoma may mimic clinically acute appendicitis and investigation tools sometimes may not provide proper diagnosis. Complete resection results in improved survival.

Figure 1

Abdominal native radiography.

Figure 2

Terminal ileum intussusception caused by Burkitt lymphoma.

Figure 3

Des intussusception of terminal ileum with Burkitt Lymphoma.

Figure 4

Macroscopic view of opened terminal ileum and Burkitt lymphoma.

Figure 5

Solid sheets of medium sized neoplastic lymphocytes infiltrating between layers of muscularis propria (×10; Giemsa stain).

Figure 6

Pronounced membranous immunoreactivity for CD10 of the neoplastic B-cells (×20; Immunoperoxidase).

Figure 7

A proliferation index of over 90% of neoplastic cells as determined by MIB-1 immunohistochemistry (×10; Immunoperoxidase).

Figure 8

c-myc translocation as determined by FISH analysis (fusion).

Figure 9

c-myc translocation as determined by FISH analysis (split).