A case of primary hepatic Burkitt's lymphoma.
Burkitt's lymphoma is a rare disease that belongs to the aggressive non-Hodgkin's lymphoma. Herein, we report a case of primary hepatic Burkitt's lymphoma. A 19-year-old man visited the hospital for right upper quadrant pain. He felt fatigue for two months. Physical examination revealed hepatomegaly and no palpable lymph node. He had no fever, weight loss, or night sweating. Laboratory finding showed mild anemia (hemoglobin, 12.4 g/dL), mild elevated transaminase (ALT, 52 IU/L), elevated lactate dehydrogenase (LDH, 437 IU/L), and alkaline phosphatase (ALP, 129 IU/L). The viral marker was positive for HBsAg, HBeAg, anti-HBs, and anti-HBc (IgG), and negative for anti-HBe, anti-HCV, and anti-HIV. CEA, AFP, and CA19-9 levels were within normal ranges. The HBV DNA quantitation was 1.3 x 10(9) copies/ml. Abdominal-Pelvis CT scan and abdominal MRI finding were compatible with malignant lymphoma. Liver biopsy examination confirmed Burkitt's lymphoma. No metastasis was detected in the thoracic cavity, bone marrow, and spinal fluid. The patient was treated with the combination regimen of cyclophosphamide, doxorubicin, vincristine, prednisone and high dose methotrexate. Cytosine arabinoside and methotrexate were added for CNS prophylaxis by intrathecal installation. Chemotherapy was administered every 3 weeks for fifteen cycles. Serial follow-up CT scan showed a marked decrease in the size of hepatic lesions. Follow-up CT scan and PET-CT scan were performed 4 weeks after the final cycle disclosed no definite residual or active lesion confirming the state of complete remission.
Lee
Seung Hyun
SH
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Kim
Hyung Joon
HJ
Mun
Jang Sik
JS
Oh
Hyoung-Chul
HC
Lee
Hyun Woong
HW
Choi
Chang Hwan
CH
Kim
Jeong Wook
JW
Do
Jae Hyuk
JH
Kim
Jae Gyu
JG
Chang
Sae Kyung
SK
Kim
Mi Kyung
MK
D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D002051:Burkitt Lymphoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine; D008727:Methotrexate