A Case Report of Primary Burkitt's Lymphoma of the Caecum

Koichi Nakagawa, Takahito Yagi*, Nobutomo Moriya, Shinya Ohe, Masaaki Hashimoto, Hitoshi Ohtsuki**

Department of Surgeyr, Fukuyama Daiichi Hospital
*First Department of Surgery, Okayama University School of Medicine
**First Department of Pathology, Okayama University School of Medicine

A 13-year-old boy was admitted to our hospital complaining of right lower quadrant pain. Barium enema and total colonoscopy discloseed a type 2´tumor in the caecum, which was histopathologically a Burkitt's lymphoma by biopsy. Computed tomography (CT), ultrasonography and ⁶⁷Ga-scintigraphy demonstrated regional lymph node involvement. A right hemicolectomy with D₃+αlymph node dissection was performed. Histologically the tumor had a "starry sky" pattern, and immunophenotypical analysis showed that the neoplastic cells were CD10 antigen positive and CD21 antigen negative, suggesting of early B cell origin. Both immunoglobulin heavy chain and c-myc oncogene were found to be rearranged by southern blot analysis. On post-operative day 14, combined systemic chemotherapy (modified Japan Leukemia Study Group ALL-93 protocol) and intrathecal injection of MTX and Ara-C were given. There has been no sign of recurrence, as of 12 months after the surgery. The outcome of intestinal Burkitt's lymphoma is poor, because of frequency of a leukemic change or CNS relapse. Nonetheless, it was suggested that aggressive debulking of the tumor include an extensive resection of the lymphnodes (over D₃) and that intensive adjuvant chemotherapy may provide better prognosis in therapy to limit intestinal Burkitt's lymphoma.

Key words
intestinal lymohoma, Burkitt's lymphoma

Reprint requests
Koichi Nakagawa Department of Surgery, Fukiyama Daiichi Hospital
5-14- 5 Minamizao-cho, Fukuyama City, 721 JAPAN

Accepted
November 13, 1996

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