BACKGROUND/AIMS: The endoscopic and clinical findings of gastrointestinal (GI) Burkitt lymphoma in Koreans are not well known. METHODS: From January 1995 to July 2007, 80 patients (47 adults and 33 children) were diagnosed with Burkitt lymphoma at our institution. The clinical and endoscopic manifestations were analyzed in the adult patients (n=20, median age=52 yr) with GI Burkitt lymphoma. RESULTS: The most frequent symptom was abdominal pain (50%) followed by epigastic soreness (30%). Among the 20 patients with GI Burkitt lymphoma, 11 (55%) had gastric lesions, 4 (20%) had colonic lesions, 3 (15%) had both gastric and duodenal lesions, 1 (5%) had both gastric and colonic lesions, and 1 (5%) had gastric, duodenal and colonic lesions. For the 13 patients who had endoscopic pictures available, the most common type of disease was the ulcerative type (38.5%) followed by the ulcerofungating and ulceroinfiltrative types (23.1% and 23.1%, respectively). Most of the patients were diagnosed with advanced disease. The most common clinical stage was stage IVE (60%) by the Musshoff staging system. All 20 patients received combination chemotherapy, and the 5-year survival rate was 64%. CONCLUSIONS: For patients with GI Burkitt lymphoma, the most commonly involved site was the stomach. Most lesions were ulcerative with or without fungating morphology. Considering the advanced stage of most patients, the prognosis after systemic chemotherapy was favorable.
Abdominal Pain ; Adult ; Burkitt Lymphoma ; Colon ; Drug Therapy, Combination ; Humans ; Prognosis ; Stomach ; Survival Rate ; Ulcer

PURPOSE: This study was conducted to evaluate outcomes in adult patients with Burkitt lymphoma (BL) or Burkitt-like lymphoma treated with an rituximab plus hyper-CVAD (R-hyper-CVAD) regimen by focusing on tolerability and actual delivered relative dose intensity (RDI). MATERIALS AND METHODS: Patients > or = 20 years of age and pathologically diagnosed with BL or Burkitt-like lymphoma were treated with at least one cycle of R-hyper-CVAD as the first-line treatment in this study. Eligible patients' case report forms were requested from their physicians to obtain clinical and laboratory data for this retrospective study. RESULTS: Forty-three patients (median age, 51 years) from 14 medical centers in Korea were analyzed, none of which were infected with human immunodeficiency virus. The majority of patients had advanced diseases, and 24 patients achieved a complete response (75.0%). After a median follow-up period of 20.0 months, 2-year event-free and overall survival rates were 70.9% and 81.4%, respectively. Eleven patients (25.6%) were unable to complete the R-hyper-CVAD regimen, including six patients due to early death. The RDIs of adriamycin, vincristine, methotrexate, and cytarabine were between 60% and 65%, which means less than 25% of patients received greater than 80% of the planned dose of each drug. Poor performance status was related to the lower RDIs of doxorubicin and methotrexate. CONCLUSION: R-hyper-CVAD showed excellent treatment outcomes in patients who were suitable for dose-intense chemotherapy. However, management of patients who are intolerant to a dose-intense regimen remains problematic due to the frequent occurrence of treatmentrelated complications.
Adult ; Burkitt Lymphoma ; Cytarabine ; Doxorubicin ; Drug Therapy ; Follow-Up Studies ; HIV ; Humans ; Korea ; Lymphoma* ; Methotrexate ; Retrospective Studies ; Survival Rate ; Vincristine

Burkitt's lymphoma is a high grade non-Hodgkin's lymphoma of B-cell origin. There are three clinical subtypes, namely, endemic African, sporadic American and human immunodeficiency-associated subtype. It usually occurs in children or younger person. Sporadic American Burkitt lymphoma involves mainly the abdomen and rarely head and neck. Complex chemotherapy is the choice of treatment. We present one case of sporadic American Burkitt lymphoma that involves the nasopharynx manifested with frequent epistaxis and nasal obstruction. Clinical and histological features are reviewed.
Abdomen ; B-Lymphocytes ; Burkitt Lymphoma* ; Child ; Drug Therapy ; Epistaxis ; Head ; Humans ; Lymphoma, Non-Hodgkin ; Nasal Obstruction ; Nasopharynx ; Neck

Primary gastric tumors are very rare in children. Burkitt lymphoma is a common type of non-Hodgkin's lymphoma, and gastric Burkitt lymphoma usually occurs in the aged. When involving the gastrointestinal tract, primary gastric Burkitt lymphoma is very rare in younger childhood. Many gastric lymphomas including mucosa-associated lymphoid tissue lymphoma are associated with Helicobacter pylori infection or acute bleeding symptom. We report a seven-year-old boy who presented with only some vomiting and postprandial pain. His upper gastrointestinal endoscopy and biopsy revealed a large primary Burkitt lymphoma with no acute bleeding and no evidence of H. pylori infection. After chemotherapy, he remains in remission.
Biopsy ; Burkitt Lymphoma* ; Child* ; Drug Therapy ; Endoscopy, Gastrointestinal ; Gastrointestinal Tract ; Helicobacter pylori ; Hemorrhage ; Humans ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Male ; Stomach Neoplasms ; Vomiting

The t(8;14)(q24;q32) translocation or its variants, t(2;8)(p12;q24) and t(8;22)(q24;q32) are classically seen in Burkitt's lymphoma, but are also found in diffuse large cell lymphoma (DLCL). Burkitt's lymphoma is very rare in Korea and t(8;14) or its variants have not been reported. We report a case of DLCL (B-cell type) with t(8;22) and additional chromosomal abnormalities. The patient, 45-year-old male, complained intermittent abdominal pain. The histologic examination of sigmoid colon revealed DLCL. Lymphoma cells were counted about 58.8% of all nucleated cells in bone marrow aspiration and showed surface membrane immunoglobulin positivity. Chromosome study of bone marrow aspiration was done using high resolution banding technique. The karyotype was 47,XY,+1,del(6)(q21),t(8;22)(q24;q11),del(13)(q31),der(14)t(1;14)(q23;q32)?, del(17)(p11) in all of the nineteen metaphases which were analyzed. Although he was treated by chemotherapy and radiotherapy, lymphoma cells were increased in peripheral blood and he expired.
Abdominal Pain ; Bone Marrow* ; Burkitt Lymphoma ; Chromosome Aberrations ; Colon, Sigmoid ; Drug Therapy ; Humans ; Immunoglobulins ; Karyotype ; Korea ; Lymphoma ; Lymphoma, Large B-Cell, Diffuse* ; Male ; Membranes ; Metaphase ; Middle Aged ; Radiotherapy

PURPOSE: The aim of this study was to determine the prognostic factors and treatment outcome of for elderly patients (age>or=60 at time of diagnosis) with aggressive non-Hodgkin's lymphoma (NHL). MATERIALS AND METHODS: We analyzed 52 patients diagnosed with aggressive NHL between January 1990 and May 2000. RESULTS: The patient's median age was 69 years (range: 60~92). Thirty-two (61.5%) patients were male. Patients included those with diffuse large B cell (53.8%), peripheral T cell (23.1%), AILD-like T-cell (3.8%), angiocentric (3.8%), mantle cell (3.8%), Burkitt's lymphoma (3.8%), and others (7.9%). International prognostic index (IPI) parameters were as follows: elevated LDH (60.8%), ECOG performance status>or=2 (32.7%), advanced stage (III/IV, 62.7%), and extranodal site>or=2 (11.5%). Twenty-six (50.0%) patients demonstrated a high and high-intermediate IPI. The median follow-up for surviving patients was 26.6 months. The overall median survival was 22.7 months and the 2-year survival rate was 46.9%. Among the 49 patientstreated with chemotherapy, 28 (57.1%) patients achieved complete remission (CR). Univariate analysis identified 8 prognostic factors for overall survival: age<70 (P=0.04), low/low-intermediate IPI (P=0.02), good performance (P= 0.04), normal WBC (P=0.008), normal Hb (P=0.02), normal LDH (P=0.04), CR on first line therapy (P<0.001), and absence of B symptom (P=0.001). In the multivariate analysis, the independent prognostic factors for improved overall survival were age <70 (P=0.03), low/low-intermediate IPI (P=0.03), normal WBC (P=0.006), and CR on first line therapy (P<0.001). CONCLUSION: In our experience, even elderly patients (>or=60 years) with aggressive NHL can be successfully treated with conventional chemotherapy and the important prognostic factors for survival are age, IPI, initial WBC, and CR on first line treatment.
Aged* ; Burkitt Lymphoma ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Male ; Multivariate Analysis ; Survival Rate ; T-Lymphocytes ; Treatment Outcome*

Tumor lysis syndrome is a serious complication of malignancy, resulting from the massive and rapid release of cellular components into the blood. Generally, it occurs after initiation of chemotherapy. The onset of spontaneous tumor lysis syndrome (STLS) before anti-cancer treatment is rare and occurs mostly in Burkitt lymphoma and non-Hodgkin's lymphoma. There are only a few case reports in children. Here, we report a case of STLS secondary to T-cell acute lymphoblastic leukemia (ALL), which presented with urinary stone and subsequent acute kidney injury with severe hyperuricemia. Occult malignancy should be considered in case of unexplained acute kidney injury with extreme hyperuricemia.
Acute Kidney Injury* ; Burkitt Lymphoma ; Child ; Drug Therapy ; Humans ; Hyperuricemia* ; Lymphoma, Non-Hodgkin ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; T-Lymphocytes ; Tumor Lysis Syndrome* ; Urinary Calculi*

Primary gastric lymphomas can be defined as lymphomas which are confined to the stomach without systemic metastasis. Primary gastric Burkitt's lymphoma is a rare disease that belongs to the aggressive non-Hodgkin's lymphomas. Chemotherapy is the mainstay of treatment, even in the localized disease. We report a case of primary gastric Burkitt's lymphoma in a 24-year-old female presenting with an intermittent epigastric pain for 3 months. Upper gastroduodenal endoscopy detected an ulcer with thickened folds on the greater curvature side of the lower body, and histologic examination of the biopsy specimens revealed infiltration of medium-sized lymphoblasts with characteristic "starry sky" macrophages. Abdominal CT scan demonstrated marked gastric wall thickening and regional lymph node enlargement.
Biopsy ; Burkitt Lymphoma* ; Drug Therapy ; Endoscopy ; Female ; Humans ; Lymph Nodes ; Lymphoma ; Lymphoma, Non-Hodgkin ; Macrophages ; Neoplasm Metastasis ; Rare Diseases ; Stomach ; Tomography, X-Ray Computed ; Ulcer ; Young Adult

Primary gastric lymphomas can be defined as lymphomas which are confined to the stomach without systemic metastasis. Primary gastric Burkitt's lymphoma is a rare disease that belongs to the aggressive non-Hodgkin's lymphomas. Chemotherapy is the mainstay of treatment, even in the localized disease. We report a case of primary gastric Burkitt's lymphoma in a 24-year-old female presenting with an intermittent epigastric pain for 3 months. Upper gastroduodenal endoscopy detected an ulcer with thickened folds on the greater curvature side of the lower body, and histologic examination of the biopsy specimens revealed infiltration of medium-sized lymphoblasts with characteristic "starry sky" macrophages. Abdominal CT scan demonstrated marked gastric wall thickening and regional lymph node enlargement.
Biopsy ; Burkitt Lymphoma* ; Drug Therapy ; Endoscopy ; Female ; Humans ; Lymph Nodes ; Lymphoma ; Lymphoma, Non-Hodgkin ; Macrophages ; Neoplasm Metastasis ; Rare Diseases ; Stomach ; Tomography, X-Ray Computed ; Ulcer ; Young Adult

The case of a 23-year-old female treated with aggressive high-dose therapy for Burkitt's lymphoma is reported. A positron emission tomography and computed tomography scan after completion of chemotherapy revealed a residual hypermetabolic lesion in the right pelvic cavity. A pelvic magnetic resonance imaging scan showed circumferential wall thickening at the tip of the appendix. A laparoscopic exploration and appendectomy were performed, and a pathologic examination of the resected appendix revealed xanthogranulomatous appendicitis. This is a rare case of a xanthogranulomatous appendicitis mimicking remnant Burkitt's lymphoma after completion of chemotherapy.
Appendectomy ; Appendicitis* ; Appendix ; Burkitt Lymphoma* ; Drug Therapy* ; Female ; Humans ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Young Adult