Abstract:
Burkitt lymphoma (BL) is an aggressive form of lymphoma that occurs due to translocation of the c-myc proto-oncogene on chromosome 8. BL is characterized by three distinct groups: African/endemic variant, immunosuppressive variant, or sporadic variant. Most cases of the sporadic variant occur in patients less than 40 years of age with a median age of 30 at diagnosis and are primarily seen in Caucasians. An immunocompetent 69-year-old male presented with subacute onset weakness in the lower extremities. Magnetic resonance imaging (MRI) of the lumbar spine revealed a mass in the right paraspinal musculature with epidural extension, neural foraminal narrowing, and severe spinal canal stenosis in L2-L5. MRI of the thoracic spine revealed significant T5-T6 cord compression due to metastatic masses. Further diagnostic imaging revealed diffuse lymphadenopathy within the mediastinum and abdomen. Subsequently, the patient underwent a core needle biopsy of the left axillary lymph node, which revealed cluster of differentiation 20 and 10 (CD20 and CD10), c-myc, and B-cell lymphoma 6 (Bcl-6) positive lymphoid cells. A diagnosis of BL was made. The patient was treated with oral steroids and received one round of radiation therapy. The patient opted to forgo any antitumor treatment and was discharged to hospice. Primary lymphomas of the central nervous system (CNS) account for <5% of all CNS tumors. Approximately 5-10% of CNS lymphomas are recorded as BL, with the majority classified as high-grade B-cell lymphomas. Paraspinal involvement with BL is rare and not commonly seen in the sporadic variant.
摘要:
伯基特淋巴瘤(BL)是一种侵袭性淋巴瘤,由于c-myc原癌基因在8号染色体上的易位而发生。BL的特点是三个不同的群体:非洲/地方性变异,免疫抑制变体,或零星变体。大多数散发性变异病例发生在40岁以下的患者中,诊断时的中位年龄为30岁,主要见于白种人。一名具有免疫能力的69岁男性,下肢出现亚急性发作无力。腰椎的磁共振成像(MRI)显示右侧椎旁肌系统有硬膜外伸,神经椎间孔狭窄,L2-L5严重椎管狭窄。胸椎的MRI显示,由于转移性肿块,T5-T6脊髓受到明显压迫。进一步的诊断成像显示纵隔和腹部弥漫性淋巴结肿大。随后,患者接受了左腋窝淋巴结的芯针活检,显示分化簇20和10(CD20和CD10),c-myc,B细胞淋巴瘤6(Bcl-6)阳性淋巴样细胞。诊断为BL。患者接受口服类固醇治疗,并接受了一轮放射治疗。患者选择放弃任何抗肿瘤治疗,并出院到临终关怀医院。中枢神经系统(CNS)的原发性淋巴瘤占所有CNS肿瘤的<5%。大约5-10%的中枢神经系统淋巴瘤记录为BL,大多数被归类为高级别B细胞淋巴瘤。BL的椎旁受累很少见,在散发性变体中并不常见。