Evolution Of An Atypical Case Of Burkitt Lymphoma
Lancet 2: Sept 26 1970; 672
View Original Source →Abstract
Seven previously untreated patients and two previously treated patients with advanced nonHodgkin’s lymphoma (Stages III and IV) and favorable histologic subtypes had spontaneous regression of their lymphomas. Regressions were either complete or partial and were frequently durable. Six of the seven patients who had spontaneous regression of their lymphomas prior to any therapy have yet to require treatment. Seven of the nine spontaneous regressions occurred in a group of 44 patients who were followed with initial therapy deferred. Six patients had regression of their lymphomas prior to any therapy and one patient had previously received a small field of radiation therapy. Temporary spontaneous regression of lymphoma may be common in selected patients with favorable histologies and advanced disease in whom initial therapy is deferred.
Case Details
Personal Characteristics
A girl 12 years old
Clinical Characteristics
Swelling of the left side of the face, fever, and pallor. On examination the gums were swollen; there was no hepatosplenomegaly. A mass was found in both iliac fossae, and on gynecological examination an elastic tumour was felt, believed to be ovarian.
Remission Characteristics
Spontaneous clinical and haematological remission in march: the face lesions disappeared; and the red-cell count rose to 5 million/mm3, the haemoglobin to 13.9 gm/100 ml, the platelets to 275,000/mm3, and the lymphocytes to 8,700/mm3, (11.5% lymphocytes).
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Cyclophosphamide treatment
Non-Clinical Treatment
A small dose of oral penicillin
Additional Notes
Laparotomy on February 26, 1970, revealed ovarian tumours, the size of oranges, on both sides. The ovarian tumours were not removed. At a second operation on March 5, the tumours were found to be so much smaller that the ovaries appeared almost normal; the ovaries were therefore not removed. The remission lasted till May when the anaemia, leucopenia, and thrombocytopenia reappeared, and laboratory findings suggested lymphatic leukaemia. The bonemarrow was infiltrated with 66% reticulum hystiocytic monocytoid immature cells. At this point, cyclophosphamide treatment was started, and there was a prompt response: The blood and bone-marrow pictures became nearly normal. On June 10, the bone-marrow showed only 7% reticulum cells, and the blood contained 4.2 million red cells, 5,300 white cells, and 114,000 platelets/mm3. This is the picture at the time of writing (August 12).