Burkitt lymphoma presenting as unilateral tonsil enlargement in an adolescent:a case report and literature review

doi:10.16150/j.1671-2870.2024.01.010

Abstract

Abstract:

Burkitt lymphoma is a highly aggressive B-cell non-Hodgkin lymphoma characterized by rapid growth, and Burkitt lymphoma originating in the tonsil is rare. Most of the cases have no obvious specific symptoms in the early stage, and the clinical symptoms are varied. Children’s symptoms are more atypical, which are easy to be misdiagnosed and missed. We report a case of adolescent with unilateral tonsil enlargement in our hospital, who was diagnosed with Burkitt lymphoma (BL). For patients with rapid enlargement of the tonsils in a short period, asymmetry of the tonsils (Brodskyscale tonsil size difference ≥ 2 degrees), mainly local symptoms but without obvious systemic symptoms, and rare enlarged lymph nodes in the neck, and no obvious abnormalities in laboratory tests, CT or MRI examination of the neck, or further PET/CT examination should be completed in time. When suspected malignant tumors revealed on imaging, especially high value of SUVmax on PET/CT, tonsil biopsy should be performed. Early detection. Early diagnosis can improve the prognosis of Burkitt lymphoma. In this case, the diagnosis was timely and accurate. Surgical resection of the left tonsil alleviated local symptoms in this cas, and chemotherapy treatment was timely completed after postoperative pathology. Efficacy of surgery combined with chemotherapy is good for the patient and long-term follow-up is available.

Key words: Palatine tonsil, Adolescent, Burkitt's lymphoma

CLC Number:

LIU Xiuling, SUN Yanyan. Burkitt lymphoma presenting as unilateral tonsil enlargement in an adolescent:a case report and literature review[J]. Journal of Diagnostics Concepts & Practice, 2024, 23(01): 77-82.

Figures/Tables 4

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Table 1

Clinical manifestations, diagnosis and treatment of 8 cases of children or adolescent BL

病例	文献	国家	性别	年龄（岁）	术前症状	查体	活检方式	病理结果	治疗
1	本文	中国	男	12	发音含糊，咽部不适2 d	左侧扁桃体Ⅲ°，超越中线，扁桃体表面见白色假膜附着，组织颜色发暗，右侧扁桃体Ⅰ°，咽腔狭窄	左侧扁桃体切除术	伯基特淋巴瘤Ⅲ期	化疗
2	武小芳等2023	中国	男	3	睡眠打鼾3个月，扁桃体增大20天	右侧扁桃体Ⅲ°，表面有灰白色坏死样物	右侧扁桃体切除术	伯基特淋巴瘤Ⅱ期	ABA3疗程化疗
3	Spini R等2021	西班牙	女	14	咽痛3周抗生素治疗无效	左扁桃体肥大，超越中线，同侧软腭隆起内侧有溃疡区域，触诊时硬度较低。	左侧扁桃体切除术	伯基特淋巴瘤	静脉、口腔和鞘内治疗
4	Toader C等2016	罗马尼亚	男	5	睡眠呼吸暂停、单侧扁桃体增大3周	腺样体肥大和左扁桃体Ⅱ°，实验室检测在正常范围内。	双侧扁桃体切除术	伯基特淋巴瘤期Ⅰ期(Murphy分型)	治疗以化疗为主，包括给予鞘内化疗
5	CuestasG等2015	西班牙	男	7	打鼾3周	双侧扁桃体肥大	双侧扁桃切除体	伯基特淋巴瘤	静脉，口腔和鞘内联合治疗在3个月内进行了4个周期
6	Banthia V等2003		男	14	轻度吞咽困难2周	右侧大的无压痛扁桃体肿块伴黏膜溃疡	右侧扁桃体切除术	伯基特淋巴瘤	环磷酰胺、长春新碱、阿霉素、甲氨蝶呤和鞘内阿糖胞苷
7	Kraus M等 1990	以色列	男	10	咽痛2周	左侧扁桃体肿大，可见中央坏死区域被发炎和水肿的扁桃体组织包围。左上颈动脉及下颌下淋巴结肿大，轻度压痛。无肝脾肿大，全身检查正常	左扁桃体切除术	伯基特淋巴瘤	阿霉素、环磷酰胺、长春新碱、强的松和鞘内甲氨蝶呤联合化疗6个疗程
8	Poulsen等1982	丹麦	男	2	轻微吞咽困	右侧扁桃体旁2 cm×3 cm×2 cm肿物	右侧扁桃体切除术	伯基特淋巴瘤	椎管内给予环磷酰胺、长春新碱、强的松以及甲氨蝶呤化疗，中枢神经系统进行预防性放射治疗

Table 1

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