Evolution Of An Atypical Case Of Burkitt Lymphoma
Jamra, M., Carvalho, R. P., & Dalldorf, G. (1970). Evolution of an atypical case of Burkitt lymphoma. Lancet (London, England), 2(7674), 672. https://doi.org/10.1016/s0140-6736(70)91449-2
View Original Source →Case Details
Disease Location
Left side of face, iliac fossa, ovary
Personal Characteristics
12 -year-old female brazilian
Clinical Characteristics
Atypical case of burkitt lymphoma patient was admitted on feb 5, 1970 with swelling of the left side of the face, fever and pallor. On exam, the gums were swollen, a mass was found in both iliac fossa and on gynecological exam, an elastic tumor was felt, believed to be ovarian lab findings: rbc 2.9million/c.mm, wbc 900/c.mm (stab neutrophils 2%, segmented neutrophils 8%, mature lymphocytes 78%, monocytes 12% with a few immature monoblasts), platelet 116,000/c.mm, sternal bone-barrow showed myeloblasts 10%, paramyeloblasts 2.2%, monocytic immature cells 17%, granulocytic cells 14%, erythroblasts 26.8%, and mature lymphocytes 24.4% laparotomy of feb 26, 1970 revealed ovarian tumors the size of oranges on both sides. Histological exam of the biopsy specimens showed starry-sky pattern with lymphoblastic and reticulum-cell proliferation typical of burkitt lymphoma. The ovarian tumors were not removed without any specific reatment, only a small dose of oral penicillin was given remission lasted until may when the anemia, leucopenia, and thrombocytopenia reappeared. Lab findings suggested lymphatic leukemia the bone marrow was infiltrated with 66% reticulum-hystiocytic monthsocytid immature cells cyclophsphamide treatment was started with a prompatient response serum samples were tested serially for precipitating and immunofluorescent antibodies against jiyoye antigen and fixed jiyoye cells and for heterophilic antibodies. (not sure how relevant this is but there is a table in the article, this article was requested therefore i can't link it but you should have the pdf if you want to go into the article, basicaly i think it's saying there was an appearance of anti-herpes-like-virus antibodies which decreased after remission that was induced by cyclophosphamide.)
Remission Characteristics
After the oral dose of penicillin, there was a spontaneous clinical and hematological remission in march--the face lesions disappeared, the rbc count rose to 5million/c.mm, the hemoglobin to 13.9g/100ml, platelets to 275,000/c.mm, and the lymphocytes to 8,700/c.mm (11.5% lymphocytes) at a second operation on march 5, the tumors were found to be so much small that the ovaries appeared almost normal, the ovaries were thus not removed remission lasted until may after cyclophosphamide, the blood and bone marrow became nearly normal on june 10, the marrow showed only 7% reticulum cells and the blood contained 4.2million rbc, 5300 wbc, and 114,000 platelets/c.mm
Treatment & Mechanisms
Proposed Remission Mechanisms
Induced by cyclophosphamide
Clinical Treatment
Oral penicillin cyclophosphamide
Non-Clinical Treatment
None reported