title: Burkitt lymphoma of the oral cavity: an atypical presentation.
abstract: Burkitt lymphoma (BL) is an aggressive form of non-Hodgkin B-cell lymphoma with 3 variants: endemic, sporadic, and immunodeficiency-associated types. The sporadic form, most commonly involving the abdomen and ileocecal region, presents as an abdominal mass, rarely presenting in the orofacial region. A 36-year-old Indian female presented to the Hospital of the University of Pennsylvania for evaluation of a persistent intraoral swelling ulceration of the lower right mandibular alveolar ridge with minimal bony invasion. Progressive systemic symptoms of fatigue, weakness, and fever developed without resolution following treatment for a presumed odontogenic infection in the 4 weeks before presentation. An incisional biopsy revealed a diffuse proliferation of intermediate- to large-sized lymphocytes with multiple small peripheral nucleoli, scant cytoplasm, and nuclear pleomorphism. Nearly all cells displayed Ki67 expression. A final diagnosis of BL was rendered following confirmation of a cMYC translocation by fluorescence in situ hybridization. This article presents a case of the sporadic form of BL with atypical presentation clinically and morphologically, primarily involving the oral soft tissue.
authors.affiliation: Perth Orofacial Pain & Oral Medicine Centre, St. John of God Hospital, Subiaco Clinic, Subiaco, Western Australia 6008, Australia. ramesh.balasubramaniam@uwa.edu.au
authors.forename: Ramesh
authors.initials: R
authors.lastname: Balasubramaniam
authors.forename: Ami
authors.initials: A
authors.lastname: Goradia
authors.forename: Lena N
authors.initials: LN
authors.lastname: Turner
authors.forename: Eric T
authors.initials: ET
authors.lastname: Stoopler
authors.forename: Faizan
authors.initials: F
authors.lastname: Alawi
authors.forename: Dale M
authors.initials: DM
authors.lastname: Frank
authors.forename: Martin S
authors.initials: MS
authors.lastname: Greenberg
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002051:Burkitt Lymphoma / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005887:Gingival Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D036502:Infusions, Intralesional; D008339:Mandibular Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics; D014178:Translocation, Genetic; D014750:Vincristine / Q000008:administration & dosage
chemical_list: C489427:MYC protein, human; D016271:Proto-Oncogene Proteins c-myc; D016179:Granulocyte Colony-Stimulating Factor; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide