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应对罕见表现:以空肠肿物形式呈现的复发性伯基特淋巴瘤

Navigating Rare Presentations: Recurrent Burkitt Lymphoma Presenting as a Jejunal Mass.

作者信息

Nikumbh Tejas, Garg Archit, Mongia Himani, Abhinav Tushar, Yadav Nivesh, Asija Udit, Huang Jialing, Nadeem Danial, Kumar Kishore, Sohagia Amit

机构信息

The Wright Center for Graduate Medical Education Scranton Pennsylvania United States.

St Peter's University Hospital New Brunswick New Jersey United States.

出版信息

Clin Case Rep. 2025 Aug 28;13(9):e70763. doi: 10.1002/ccr3.70763. eCollection 2025 Sep.

Abstract

Burkitt lymphoma (BL) is an aggressive B-cell malignancy characterized by rapid progression and MYC gene translocations. Jejunal involvement in BL is rare compared to more common sites like the lymph nodes and central nervous system. Diagnosing BL in the jejunum is particularly challenging as it can mimic other gastrointestinal conditions, necessitating a high index of suspicion and histopathological confirmation. We present the case of a 37-year-old male with a history of stage III non-seminomatous testicular carcinoma, BL, deep venous thrombosis, pulmonary embolism, and hypogammaglobulinemia, who presented with abdominal pain and nausea. Imaging revealed peritoneal carcinomatosis and a left hemiabdomen mass concerning malignancy. Given his medical history of previously diagnosed BL in the gastrohepatic ligament lymph node and imaging findings, BL relapse was suspected. Push enteroscopy with biopsy confirmed the recurrence of BL in the jejunum, with positive markers for CD45, CD20, BCL6, and c-Myc. Despite aggressive supportive care, the patient succumbed to his disease. This case highlights the importance of early recognition of BL, particularly in rare extra-nodal sites like the jejunum. Further research is needed to improve early detection and treatment outcomes for patients with relapsed or refractory BL.

摘要

伯基特淋巴瘤(BL)是一种侵袭性B细胞恶性肿瘤,其特征为进展迅速和MYC基因易位。与淋巴结和中枢神经系统等更常见的部位相比,空肠受累于BL较为罕见。在空肠中诊断BL尤其具有挑战性,因为它可能模仿其他胃肠道疾病,这就需要高度的怀疑指数和组织病理学确认。我们报告一例37岁男性病例,其有III期非精原细胞瘤性睾丸癌、BL、深静脉血栓形成、肺栓塞和低丙种球蛋白血症病史,此次因腹痛和恶心就诊。影像学检查显示腹膜癌病和左半腹肿物,怀疑为恶性肿瘤。鉴于其既往在胃肝韧带淋巴结诊断为BL的病史及影像学检查结果,怀疑为BL复发。推进式小肠镜检查及活检证实空肠中BL复发,CD45、CD20、BCL6和c-Myc标记物呈阳性。尽管给予积极的支持治疗,患者仍死于该病。该病例突出了早期识别BL的重要性,尤其是在空肠等罕见的结外部位。需要进一步研究以改善复发或难治性BL患者的早期检测和治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1448/12394064/b837417dc71e/CCR3-13-e70763-g004.jpg

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