Bustamante-Bernal Marco, Galvis Juan, Matos Dubier, Sosa Omar, Syed Saad H, Padilla Osvaldo, Davis Brian, Zuckerman Marc J
Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, TX, USA.
Department of Pathology, Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, TX, USA.
Am J Case Rep. 2016 Feb 15;17:89-92. doi: 10.12659/ajcr.896070.
Burkitt's lymphoma (BL) is an uncommon cause of non-Hodgkin lymphoma in adults and accounts for only 0.1-0.5% of all malignant tumors of the colon and rectum. Very few cases of rectosigmoid and stomach BL have been reported in adults.
A 51-year-old Hispanic woman presented with a 1-month history of hematochezia, associated with a foreign-body sensation in the rectum and 7 kg weight loss. Initial laboratory workup showed normocytic anemia and positive fecal occult blood. Computed tomography of the abdomen revealed an asymmetric appearance of the stomach and pylorus with nodularity of the mucosa and thickening of the posterior wall, and a 10.8-cm rectal mass. Esophagogastroduodenoscopy and colonoscopy were performed and biopsies of the stomach and rectum were obtained; histopathology demonstrated involvement by Burkitt's lymphoma in the gastric body nodule and rectal mass. After 4 cycles of chemotherapy, a follow-up abdominal CT demonstrated complete resolution of the mural thickening of the rectum and no intra-abdominal lymphadenopathy.
Our case illustrates the importance of considering BL in the extensive differential diagnosis of rectal bleeding, change in bowel habits, and other lower and upper GI symptoms, since the rapidly growing nature of this rare malignancy requires a prompt diagnosis and initiation of appropriate therapy.
伯基特淋巴瘤（BL）是成人非霍奇金淋巴瘤的罕见病因，仅占所有结肠和直肠癌恶性肿瘤的0.1 - 0.5%。成人中直肠乙状结肠和胃BL的病例报道极少。
一名51岁的西班牙裔女性，有1个月便血病史，伴有直肠异物感和体重减轻7千克。初始实验室检查显示正细胞性贫血和粪便潜血阳性。腹部计算机断层扫描显示胃和幽门外观不对称，黏膜有结节，后壁增厚，直肠有一个10.8厘米的肿块。进行了食管胃十二指肠镜检查和结肠镜检查，并获取了胃和直肠的活检样本；组织病理学显示胃体结节和直肠肿块有伯基特淋巴瘤累及。经过4个周期的化疗后，随访腹部CT显示直肠壁增厚完全消退，无腹腔内淋巴结肿大。
我们的病例说明了在对直肠出血、排便习惯改变及其他下消化道和上消化道症状进行广泛鉴别诊断时考虑BL的重要性，因为这种罕见恶性肿瘤的快速生长特性需要及时诊断并开始适当治疗。
