Upile Tahwinder, Jerjes Waseem, Abiola Jesuloba, Kafas Panagiotis, Sandison Ann, Hamdoon Zaid, Al-Khawalde Mohammed, Radhi Hani
Department of Head and Neck Surgery, Chase Farm & Barnet NHS Trust, Enfield, UK.
Head Neck Oncol. 2012 Jun 13;4:33. doi: 10.1186/1758-3284-4-33.
Burkitt's lymphoma is a highly aggressive lymphoma. The endemic form is present with Epstein - Barr virus. The most common sites are the mandible, facial bones, kidneys, gastrointestinal tract, ovaries, breast and extra-nodal sites. We present the first reported case of a primary Burkitt's lymphoma of the postnasal space occurring in an elderly Caucasian male.
A 72-year-old Caucasian male farmer presented with a 6-week history of a productive cough and a painless left sided cervical swelling. Examination of the neck revealed a 5 cm by 5 cm hard mass in the left anterior triangle. A CT scan of the head and neck showed a soft tissue swelling in the postnasal space. Histology of the postnasal space mass showed squamous mucosa infiltrated by a high grade lymphoma. Immunohistochemical staining and in situ hybridisation confirmed the tumour to be Epstein - Barr virus Ribonucleic acid negative suggesting this was a rare sporadic form of the tumour presenting in a location that is atypical for the clinical subtype and age of the patient.
This is the first reported case of sporadic Burkitt's lymphoma of the postnasal space of an elderly Caucasian male in the absence of Epstein - Barr virus or human immunodeficiency virus infection and further serves to illustrate the diversity of histological subtypes of malignancies that may develop at this concealed site.
伯基特淋巴瘤是一种侵袭性很强的淋巴瘤。地方性伯基特淋巴瘤与爱泼斯坦-巴尔病毒有关。最常见的发病部位是下颌骨、面骨、肾脏、胃肠道、卵巢、乳腺和结外部位。我们报告了首例发生在一名老年白人男性后鼻孔间隙的原发性伯基特淋巴瘤。
一名72岁的白人男性农民,有6周的咳嗽咳痰病史,左侧颈部无痛性肿胀。颈部检查发现左前三角区有一个5厘米×5厘米的硬块。头颈部CT扫描显示后鼻孔间隙有软组织肿胀。后鼻孔间隙肿块的组织学检查显示鳞状黏膜被高级别淋巴瘤浸润。免疫组化染色和原位杂交证实肿瘤为爱泼斯坦-巴尔病毒核糖核酸阴性,提示这是一种罕见的散发型肿瘤,其发病部位对于该临床亚型和患者年龄来说并不典型。
这是首例报道的老年白人男性后鼻孔间隙散发型伯基特淋巴瘤病例,该病例无爱泼斯坦-巴尔病毒或人类免疫缺陷病毒感染,进一步说明了在这个隐蔽部位可能发生的恶性肿瘤组织学亚型的多样性。