Primary spinal Burkitt's lymphoma: Case report and literature review

Abstract

Background: Burkitt's lymphoma is a non-Hodgkin B-cell lymphoma, occurring mostly in Equatorial Africa. According to the WHO, classification is three different variants: sporadic, endemic, and immunodeficient-associated. Here, we present a patient with "sporadic" primary epidural Burkitt's lymphoma resulting in chronic low back pain (LBP).

Case description: A 63-year-old female presented with a 2-month history of LBP and the left lower extremity sciatica. The thoracolumbar MRI showed a L5 irregular, osteolytic epidural lesion that was hypointense on T1-weighted images, hyperintense on STIR studies, and inhomogeneously enhanced with contrast. Additional hypointense lesions were also seen at the L2, L3, and L4 levels. The patient underwent a L4-L5 laminectomy for piecemeal epidural resection of tumor, and a L4-S1 transpedicular screws/rod fusion. In addition, a L2-L3 radiofrequency ablation was performed. The histological examination documented a primary "sporadic" spinal Burkitt's lymphoma. The patient subsequently was treated with both radiotherapy/chemoradiotherapy.

Conclusion: Primary "sporadic" spinal Burkitt's lymphoma is rare. Following tumor resection, adjunctive radiation and chemotherapy are typically warranted.

Keywords: Burkitt; Chemotherapy; Laminectomy; Lymphoma; Spine.

Figure 1:

Preoperative thoracolumbar spine MRI showed a L5 osteolytic and epidural lesion hyperintense in sagittal STIR sequences (a) with a high and inhomogeneous post-contrast enhancement in T1-Gd axial and sagittal sequences (b and c).