Nasopharyngeal Burkitt lymphoma masquerading as adenoid hypertrophy in an adult: a diagnostic challenge

Deepika Eswari D.; Sunil Pai; Ajay Kumar; Ramnath Shenoy; David Rosario; Hanock Nischal; Herison J.

doi:10.18203/issn.2454-5929.ijohns20234163

Authors

Deepika Eswari D. Department of ENT, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India
Sunil Pai Department of ENT, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India
Ajay Kumar Department of Surgical Oncology, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India
Ramnath Shenoy Department of Medical Oncology, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India
David Rosario Department of ENT, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India
Hanock Nischal Department of ENT, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India
Herison J. Department of ENT, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20234163

Keywords:

Nasopharyngeal BL, Adenoid hypertrophy, Misdiagnosis, Diagnostic challenge, Immunohistochemistry, CT scan, Complete remission

Abstract

This case report presents the diagnostic challenges encountered in identifying nasopharyngeal Burkitt lymphoma (BL) in an 18- year-old male initially misdiagnosed with adenoid hypertrophy. BL, a rare and aggressive B-cell non-Hodgkin’s lymphoma (NHL), typically manifests in cervical lymphnodes or facial bones, making nasopharyngeal involvement unusual. The patient's symptoms progressed from nasal blockage to oropharyngeal dysphagia and neck swelling, prompting further investigation. Radiological assessments, including a CT scan, were inconclusive, leading to a diagnosis through excisional biopsy and immunohistochemistry, confirming BL with CD20, CD10, and Bcl-6 expression. Successful treatment involved six cycles of chemotherapy, resulting in complete remission. This case underscores the importance of considering rare malignancies in atypical presentations and highlights the role of comprehensive diagnostic approaches in achieving accurate and timely management.

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