title: [Primary small intestinal Burkitt lymphoma treated with rituximab-combined CODOX-M/IVAC therapy without surgical resection].
abstract: A 38-year-old man complaining of abdominal pain was admitted to our hospital and diagnosed with small bowel obstruction. Whole body computed tomography(CT)scan showed moderate right pleural effusion with pleural and anterior chest wall thickening, with a mass approximately 100 mm in diameter at the terminal ileum. Histopathological and immunohistorical analysis of the endoscopic biopsy from the terminal ileum mass revealed diffuse infiltration of medium-sized, monotonous, atypical B lymphocytes with scanty basophilic cytoplasms carrying the so-called "starry sky" appearance, and primary small intestinal Burkitt lymphoma(BL)was diagnosed. Because of his advanced clinical stage(stage IV with Ann Arbor staging system)and the need for immediate treatment, he was promptly treated with cyclophosphamide and doxorubicin without surgical resection. Fortunately this initial therapy was received without the occurrence of bowel perforation. After initiating additional rituximab combined high-dose chemotherapy consisting of alternating courses of rituximab, cyclophosphamide, vincristine, doxorubicin, and methotrexate(R-CODOX-M)and rituximab, ifosfamide, etoposide, and cytarabine(R-IVAC), he achieved complete remission and remains without signs of disease now more than seven years after his last treatment. While further investigation will of course be needed, if possible, immediate chemotherapy without surgical resection is a treatment worth considering for improving the prognosis of those with small intestinal BL.
authors.affiliation: Dept. of Internal Medicine, Matsusaka Chuo General Hospital, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Mizutani
authors.forename: Akira
authors.initials: A
authors.lastname: Umino
authors.forename: Masanori
authors.initials: M
authors.lastname: Taniguchi
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Tamaki
authors.forename: Motoaki
authors.initials: M
authors.lastname: Tanigawa
authors.forename: Kouta
authors.initials: K
authors.lastname: Tsuji
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002051:Burkitt Lymphoma / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007078:Ileal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D012074:Remission Induction; D016896:Treatment Outcome