Clinical presentation of gastric Burkitt lymphoma presenting with paraplegia and acute pancreatitis: A case report

Table 1 Clinical features of 10 previous cases of Burkitt lymphoma involving stomach, pancreas or spinal cord

Author	Age	Gender	Initial symptom	Affecting area	Biopsy area	Immunohistochemical studies	EB	HIV	Treatment	Prognosis
Kim et al[8]	69	Female	Low back pain radiating down to the right leg	Spinal cord at the L2 to L4 levels, intestine, live, bone and left supraclavicular lymph node	A posterolate-ral extradural mass lesion between L2 and L3	CD20 (+), CD79a (+), BCL-6 (+), CD10 (+), BCL-2 (-)	+	NA	NA	NA
Seo et al[9]	40	Male	Progressive pain and weakness in lower extremities	Spinal cord at the T2 to T4 levels, liver	An intraspinal extramedu-llary mass from T2 to T4, liver	CD20 (+), CD45RO (-)	NA	+	Chemotherapy and radiation therapy with HAART after surgery for intraspinal decompression and mass separation. Radiation	Died by massive pulmonary thromboembolism at 13 wk postoperatively
Chieng et al[10]	9	Male	Progressive pallor, peripheral oedema and respiratory distress	Stomach	Gastric body mass	CD20 (+), CD10 (+) and CD43 (+)	NA	NA	Induction chemotherapy with COP. Further chemotherapy included two courses of COPADAM followed by two courses of CYM and double intrathecal chemotherapy of methotrexate and hydrocortisone	Remains in clinical remission with complete resolution of the protein-losing enteropathy and no treatment related sequelae 4 yr from initial diagnosis
Bolandparvaz et al[11]	21	Male	Abdominal pain	Stomach	A huge mass in greater curvature of the stomach	NA	NA	NA	Total gastrectomy and roux-en-y esophagojejunostomy, chemotherapy was given for the patient 1 wk later without any other complication	NA
Gurzu et al[12]	60	Female	Fulminant hematemesis, recurring melena, epigastric pain, inappetence, and weight loss	Stomach	A huge mass in the antrum and posterior wall of the gastric body	CD20 (+), CD79a (+), BCL-6 (+), CD10 (+), Ki-67 (100%+), CD3 (-), CD5 (-), CD23 (-), TdT (-), bcl-2 (-), and Cyclin D1 (-)	-	NA	Distal gastrectomy	Died ten days after surgical intervention
Krugmann et al[13]	28	Male	Hematemesis and increasing abdominal pain	Stomach	A huge mass in the middle third of the stomach	CD20 (+), CD10 (+), BCL-6 (+), Ki-67 (95%+), CD3 (-), CD5 (-), CD23 (-), Cyclin D1 (-), BCL-2 (-) and TdT (-)	-	NA	Billroth-II surgical resection	Died due to lymphoma recurrence four months after onset
Liao et al[14]	26	Male	Fulminant hematemesis, abdominal pain	Stomach	A mass in the body and antrum of the stomach	CD20 (+), CD10 (+), BCL-6 (+), MUM-1 (-), CD30 (-)	NA	NA	Induction chemotherapy with two courses of R-ECHOP. Further chemotherapy included two courses of R-hyper CVAD followed by five courses of intrathecal prophylactic injection of chemotherapy drugs	Lymphoma recurrence six months after onset
Sağlam et al[15]	20	Male	Weight loss, back pain, mandible numbness, night sweats, and poor exercise tolerance	The body of the pancreas	A mass in the body of the pancreas	NA	NA	NA	Doxorubicin based combination chemotherapy	Died from sepsis during the second month of chemotherapy
Nistala et al[16]	21	Male	Jaundice, increasing swelling in the epigastric region	The head of the pancreas, cystic duct, portal vein and hepatic artery, duodenum	The first and second parts of duodenum	CD20 (+), CD10 (+), BCL-6 (+), CD5 (-), Mib-1 (99%+)	NA	NA	Two cycles of CHOP followed by hyper CVAD regimen as definitive therapy	NA
Konjeti et al[17]	68	Female	Belching, abdominal bloating and weight loss	The head of the pancreas, central hepatic duct and portal vein	The pancreatic head mass	CD20 (+), CD10 (+), C-myc (+), BCL-6 (+), CD3 (-), TdT (-), BCL-2 (-), Ki-67 (> 90%+)	NA	NA	Two cycles of chemotherapy regimen consisting of etoposide, prednisone, vincristine (Oncovin), and doxorubicin hydrochloride (Hydroxydaunorubicin hydrochloride)	Die due to the sepsis and bacteremia

EB: Epstein-Barr virus; HIV: Human Immunodeficiency Virus; HAAART: Highly active antiretroviral therapy; COP: Cyclophosphamide, vincristine and prednisolone; COPADAM: Cyclophosphamide, vincristine, prednisone, cytarabine, doxorubicin and methotrexate; CYM: Cytarabine and methotrexate; R-ECHOP: Rituximab, etoposide, cyclophosphamide, doxorubicin, vincristine and prednisone; CVAD: Cyclophosphamide, vincristine, doxorubicin, dexamethasone; CHOP: Cyclophosphamide, doxorubicin, vincristine and prednisolone; NA: Not available.