Autopsy and Case Reports
https://app.periodikos.com.br/journal/autopsy/article/doi/10.4322/acr.2019.117
Autopsy and Case Reports
Article / Clinical Case Report

Intraoral EBV-positive sporadic Burkitt lymphoma in an elderly patient with bilateral presentation

Ricardo Martínez Pedraza; Lady Paola Aristizabal Arboleda; Celeste Sánchez-Romero; Jesús Alfonso Aguirre Quiñones; Carlos de Jesús Mata Tovar; Javier Rendón Henao; Oslei Paes de Almeida

http://dx.doi.org/10.4322/acr.2019.117 Autops Case Rep, vol.9, n4, e2019117, 2019
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Abstract

Sporadic Burkitt lymphoma (SBL) is a variant of Burkitt lymphoma that occurs worldwide, affecting mainly children and young adults. Association with Epstein-Barr virus (EBV) can be identified in approximately 20-30% of cases. Herein we described a case of a 63-year-old male presenting intraoral bilateral mandibular swelling, subjacent to fixed dental prosthesis, with one month of duration. Incisional biopsies were performed, and after two days, the patient was hospitalized due to malaise and breathing difficulty, and died after a week when an abdominal tumor was detected. The mandibular biopsies revealed a diffuse proliferation of medium-sized monomorphic atypical lymphoid cells exhibiting numerous mitoses and areas of “starry-sky” pattern. The tumor showed immunohistochemical positivity for CD20, CD10, Bcl-6, and Ki-67 (≈ 100%); it was negative for CD3, Bcl-2, Vs38c, and MUM-1. Positivity for EBV was found by in situ hybridization. The final diagnosis was intraoral SBL positive for EBV. Clinical, morphological and molecular criteria are necessary for the correct diagnosis of aggressive B-cell neoplasms positive for EBV in elderly patients.

Keywords

Burkitt lymphoma, Epstein-Barr virus, Non-Hodgkin Lymphoma, Mouth neoplasms

References

Swerdlow SH, Campo E, Harris NL, et al.

 

WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th ed. Lyon, France: IARC; 2017.
 

 

Bi C-F, Tang Y, Zhang W-Y, et al. Sporadic Burkitt lymphomas of children and adolescents in Chinese: a clinicopathological study of 43 cases.

 

 

Diagn Pathol. 2012;67(1):72. [https://doi.org/10.1186/1746-1596-7-72]. [PMID:22726497]
 

 

Swerdlow S, Campo E, Harris NL, et al.

 

 

WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 3rd ed. Lyon, France: IARC; 2008.
 

 

Satou A, Asano N, Nakazawa A, et al. Epstein-Barr virus (EBV)-positive sporadic Burkitt lymphoma: an age-related lymphoproliferative disorder?

 

 

Am J Surg Pathol. 2015;39(2):227-35. [https://doi.org/10.1097/PAS.0000000000000332]. [PMID:25321330]
 

 

Casulo C, Friedberg J. Treating burkitt lymphoma in adults.

 

 

Curr Hematol Malig Rep. 2015;10(3):266-71. [https://doi.org/10.1007/s11899-015-0263-4]. [PMID:26013028]
 

 

Chuang SS, Ye H, Du MQ, et al. Histopathology and immunohistochemistry in distinguishing Burkitt lymphoma from diffuse large B-cell lymphoma with very high proliferation index and with or without a starry-sky pattern: a comparative study with EBER and FISH.

 

 

Am J Clin Pathol. 2007;128(4):558-64. [https://doi.org/10.1309/EQJR3D3V0CCQGP04]. [PMID:17875505]
 

 

Bellan C, Stefano L, Giulia F, Rogena EA, Lorenzo L. Burkitt lymphoma versus diffuse large B-cell lymphoma: a practical approach.

 

 

Hematol Oncol. 2009;27(4):182-5. [https://doi.org/10.1002/hon.914]. [PMID:19670467]
 

 

Epstein JB, Epstein JD, Le ND, Gorsky M. Characteristics of oral and paraoral malignant lymphoma: a population-based review of 361 cases.

 

 

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92(5):519-25. [https://doi.org/10.1067/moe.2001.116062]. [PMID:11709688]
 

 

Triantafillidou K, Dimitrakopoulos J, Iordanidis F, Gkagkalis A. Extranodal non-hodgkin lymphomas of the oral cavity and maxillofacial region: a clinical study of 58 cases and review of the literature.

 

 

J Oral Maxillofac Surg. 2012;70(12):2776-85. [https://doi.org/10.1016/j.joms.2012.01.018]. [PMID:22494508]
 

 

Morton LM, Wang SS, Devesa SS, Hartge P, Weisenburger DD, Linet MS. Lymphoma incidence patterns by WHO subtype in the United States, 1992-2001.

 

 

Blood. 2006;107(1):265-76. [https://doi.org/10.1182/blood-2005-06-2508]. [PMID:16150940]
 

 

Owosho AA, Bilodeau EA, Surti U, Craig FE. Large B-cell lymphoma of the base of the tongue and oral cavity: a practical approach to identifying prognostically important subtypes.

 

 

Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118(3):338-47. [https://doi.org/10.1016/j.oooo.2014.06.002]. [PMID:25151588]
 

 

Ozsan N, Cagirgan S, Saydam G, Gunes A, Hekimgil M. Epstein-Barr virus (EBV) positive diffuse large B cell lymphoma of the elderly-experience of a single center from Turkey.

 

 

Pathol Res Pract. 2013;209(8):471-8. [https://doi.org/10.1016/j.prp.2013.04.014]. [PMID:23726928]
 

 

Adam P, Bonzheim I, Fend F, Quintanilla-Martínez L. Epstein-Barr virus-positive diffuse large B-cell lymphomas of the elderly.

 

 

Adv Anat Pathol. 2011;18(5):349-55. [https://doi.org/10.1097/PAP.0b013e318229bf08]. [PMID:21841405]
 

 

Naeini YB, Wu A, O’Malley DP. Aggressive B-cell lymphomas: frequency, immunophenotype, and genetics in a reference laboratory population.

 

 

Ann Diagn Pathol. 2016;25:7-14. [https://doi.org/10.1016/j.anndiagpath.2016.07.008]. [PMID:27806850]
 

 

Castillo JJ, Beltran BE, Miranda RN, Young KH, Chavez JC, Sotomayor EM. EBV-positive diffuse large B-cell lymphoma, not otherwise specified: 2018 update on diagnosis, risk-stratification and management.

 

 

Am J Hematol. 2018;93(7):953-62. [https://doi.org/10.1002/ajh.25112]. [PMID:29984868]
 

 

Aukema SM, Kreuz M, Kohler CW, et al. Biological characterization of adult MYC-translocation-positive mature B-cell lymphomas other than molecular Burkitt lymphoma.

 

 

Haematologica. 2014;99(4):726-35. [https://doi.org/10.3324/haematol.2013.091827]. [PMID:24179151]
 

 

Queiroga EM, Gualco G, Weiss LM, et al. Burkitt lymphoma in Brazil is characterized by geographically distinct clinicopathologic features.

 

 

Am J Clin Pathol. 2008;130(6):946-56. [https://doi.org/10.1309/AJCP64YOHAWLUMPK]. [PMID:19019773]
 

 

Chen BJ, Chang ST, Weng SF, et al. EBV-associated Burkitt lymphoma in Taiwan is not age-related.

 

 

Leuk Lymphoma. 2016;57(3):644-53. [https://doi.org/10.3109/10428194.2015.1076928]. [PMID:26422188]
 

 

Cohen JI, Bollard CM, Khanna R, Pittaluga S. Current understanding of the role of Epstein-Barr virus in lymphomagenesis and therapeutic approaches to EBV-associated lymphomas.

 

 

Leuk Lymphoma. 2008;49(Suppl 1):27-34. [https://doi.org/10.1080/10428190802311417]. [PMID:18821430]
 

 

Huang H, Liu ZL, Zeng H, et al. Clinicopathological study of sporadic Burkitt lymphoma in children.

 

 

Chin Med J (Engl). 2015;128(4):510-4. [https://doi.org/10.4103/0366-6999.151106]. [PMID:25673455]
 

 

Garcia NG, Rodrigues MTV, Aleixo RQ, Oliveira DT. Burkitt Lymphoma in adult with atypical clinical presentation primarily involving the oral soft tissue.

 

 

J Craniofac Surg. 2017;28(8):e795-7. [https://doi.org/10.1097/SCS.0000000000003681]. [PMID:28328599]
 

 

Kikuchi K, Inoue H, Miyazaki Y, et al. Adult sporadic burkitt lymphoma of the oral cavity: a case report and literature review.

 

 

J Oral Maxillofac Surg. 2012;70(12):2936-43. [https://doi.org/10.1016/j.joms.2012.02.017]. [PMID:22520562]
 

 

Balasubramaniam R, Goradia A, Turner LN, et al. Burkitt lymphoma of the oral cavity: an atypical presentation.

 

 

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(2):240-5. [https://doi.org/10.1016/j.tripleo.2008.09.008]. [PMID:19138642]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publication date:
09/18/2019

5d8226b90e88259550bbec09 autopsy Articles
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