Burkitt lymphoma masquerading as nasopharyngeal angiofibroma
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20232529Keywords:
Burkitt, Lymphoma, Child, Angiofibroma, AdenoidAbstract
Primary nasopharyngeal (NP) lymphoma is a very rare tumor. Burkitt lymphoma is a subtype of non-Hodgkin’s B cell lymphoma. It is rare in the Waldeyer’s ring (3-5%). It is a highly aggressive, highly chemo sensitive lymphoma seen predominantly in childhood. Presenting a unique case of an 11 year old, male child presented to us with the chief complaints of bilateral nasal obstruction since 1 month, 6-7 episodes of nasal bleed since 1 week. Radiologically, a large soft tissue density mass lesion was seen in the region of nasopharynx, extending into the para/retro pharyngeal space. Excisional biopsy of the mass lesion histopathologic evaluation was suggestive of small round blue cell tumor, later confirmed to be Burkitt lymphoma after a bone marrow biopsy. Nasopharyngeal NHL should be kept in mind as a differential diagnosis, apart from inflammatory adenoid hypertrophy and benign tumors such as JNA while evaluating a nasopharyngeal mass in children. Nasopharyngeal NHL are highly chemo sensitive, therefore, an early diagnosis can aid timely commencement of chemotherapy and prevent progression and complications of the disease.
References
Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375-90.
Saul SH, Kapadia SB. Primary lymphoma of Waldeyer’s ring. Clinicopathologic study of 68 cases. Cancer. 1985;56(1):157-66.
Wu R-Y, Li Y-X, Wang W-H, Jin J, Wang S-L, Liu Y-P et al. Clinical disparity and favorable prognoses for patients with Waldeyer ring extranodal nasal-type NK/T-cell lymphoma and diffuse large B-cell lymphoma. Am J Clin Oncol. 2014;37(1):41-6.
Elizabeth MM, Rosemary R, Beverly G. Burkitt’s Lymphoma. Lancet. 2012;379:1234-44.
Tan LH. Lymphomas involving Waldeyer’s ring: placement, paradigms, peculiarities, pitfalls, patterns and postulates. Ann Acad Med Singapore. 2004;33(4):15-26.
Bayazian G, Safdarian M, Ebrahimnejad S. Spontaneous adenoid hemorrhage mimicking upper gastrointestinal bleeding. Online J otolaryngol. 2017;7(1).
Page C, Biet A, Liabeuf S, Strunski V, Fournier A. Serious spontaneous epistaxis and hypertension in hospitalized patients. Eur Arch Otorhinolaryngol. 2011;268(12):1749-53.
Pao WJ, Hustu HO, Douglass EC, Beckford NS, Kun LE. Pediatric nasopharyngeal carcinoma: long term follow-up of 29 patients. Int J Radiat Oncol Biol Phys. 1989;17(2):299-305.
Makhasana JAS, Kulkarni MA, Vaze S, Shroff AS. Juvenile nasopharyngeal angiofibroma. J Oral Maxillofac Pathol. 2016;20(2):330.
Allam W, Ismaili N, Elmajjaoui S, Elgueddari BK, Ismaili M, Errihani H. Primary Nasopharyngeal non-Hodgkin lymphomas: a retrospective review of 26 Moroccan patients. BMC Ear Nose Throat Disord. 2009;9(1):11.
Nguyen L, Papenhausen P, Shao H. The Role of c-MYC in B-Cell Lymphomas: Diagnostic and Molecular Aspects. Genes, 2017;8(4):116.
Goldman S, Smith L, Anderson J, Perkins S, Harrison L, Geyer M, Gross T et al. Rituximab and FAB/LMB 96 chemotherapy in children with Stage III/IV B-cell non-Hodgkin lymphoma: a Children’s Oncology Group report. Leukemia. 2012;27(5):1174-7.