Aslan Gaffar
Department of Otorhinolaryngology-Head and Neck Surgery, Istanbul Bilim University Faculty of Medicine, Istanbul, Turkey.
J Med Case Rep. 2013 Mar 8;7:60. doi: 10.1186/1752-1947-7-60.
Burkitt's lymphoma is a highly aggressive, small, non-cleaved B-cell non-Hodgkin's lymphoma. In the sporadic form of the disease that occurs in non-endemic areas around the world, most commonly in developed countries, patients usually present with an abdominal mass that frequently involves the ileocecal region of the bowel; ocular or orbital involvement is rare. Primary disease of the sinuses is uncommon and, to the best of our knowledge, that of the anterior septum has never been described. We report the diagnosis and successful management of Burkitt's lymphoma originating from the nasal septum in a male patient.
An otherwise healthy 78-year-old Caucasian man who did not smoke cigarettes was admitted to our Ear, Nose and Throat outpatient clinic with the complaint of nasal obstruction due to left-sided nasal septal thickening. Paranasal computerized tomography revealed a well-circumscribed solid mass originating from his anterior nasal septum and obstructing his airway. The final diagnosis of Burkitt's lymphoma was verified by immunohistochemical studies. Our patient had a good clinical outcome after chemoradiotherapy, with no problems reported to date in the second year of follow-up.
We provide what we believe to be the first report of a case of sporadic Burkitt's lymphoma involving the nasal septum, and describe the efficacy of first-line chemotherapy. Being an original case report with broader clinical impact across more than one area of medicine, this case presentation has the potential to significantly advance our understanding of Burkitt's lymphoma and we emphasize the need to include this disease in the differential diagnosis of patients presenting with a nasal septal mass.
伯基特淋巴瘤是一种侵袭性很强的小型非裂细胞性B细胞非霍奇金淋巴瘤。在世界各地非地方性流行区域散发形式的该疾病中，最常见于发达国家，患者通常表现为腹部肿块，常累及回盲部肠段；眼部或眼眶受累罕见。鼻窦原发性疾病不常见，据我们所知，鼻中隔前部的原发性疾病从未被描述过。我们报告了一名男性患者鼻中隔起源的伯基特淋巴瘤的诊断及成功治疗情况。
一名78岁、不吸烟的健康白种男性因左侧鼻中隔增厚导致鼻塞而入住我们的耳鼻喉科门诊。鼻窦计算机断层扫描显示一个边界清晰的实性肿块起源于他的鼻中隔前部并阻塞气道。免疫组化研究证实了伯基特淋巴瘤的最终诊断。我们的患者在放化疗后临床结局良好，随访第二年至今未报告任何问题。
我们提供了我们认为首例关于累及鼻中隔的散发性伯基特淋巴瘤病例的报告，并描述了一线化疗的疗效。作为一份在多个医学领域具有更广泛临床影响的原始病例报告，本病例介绍有可能显著增进我们对伯基特淋巴瘤的理解，并且我们强调在对出现鼻中隔肿块的患者进行鉴别诊断时需要考虑这种疾病。
