SHM Converge Scientific Abstract ePoster Gallery-A Case of Burkitt Lymphoma in an Older Adult

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This case report describes an 84-year-old woman with hypertension and hyperlipidemia who presented with one month of progressive vague abdominal and systemic symptoms, including right-sided abdominal pain, poor oral intake, nausea, vomiting, fatigue, weakness, and a 20-pound unintentional weight loss. She had previously been active and independent, but her condition worsened after developing neck pain, stiffness, and low-grade fevers several weeks earlier.<br /><br />On exam, she appeared chronically ill, had decreased breath sounds at the left base, severe abdominal distension, and right upper/lower quadrant tenderness. CT imaging showed ascites, bowel wall thickening in the right upper quadrant, and diffuse pathologic lymphadenopathy. Paracentesis revealed a very high nucleated cell count with predominantly lymphocytic/monocytic fluid, low serum-ascites albumin gradient, and cytology demonstrating a monoclonal B-cell population consistent with B-cell lymphoma. Surgical exploration noted cloudy peritoneal fluid, malignant-appearing peritoneal nodules, and diffuse omental infiltration.<br /><br />Laboratory findings shortly after surgery suggested spontaneous tumor lysis syndrome, with elevated uric acid, phosphorus, LDH, leukocytosis, and acute kidney injury. Biopsy ultimately confirmed Burkitt lymphoma: tumor cells were positive for CD10, BCL6, and MYC, had a Ki-67 proliferation index of 95%, and showed the characteristic t(8;14) translocation.<br /><br />The report emphasizes that Burkitt lymphoma is a very aggressive B-cell non-Hodgkin lymphoma driven by MYC translocation, typically seen in children but possible in older adults, especially the sporadic subtype, which often presents as a large abdominal mass. Because of its rapid growth, it can present with B symptoms and tumor lysis syndrome. Treatment requires intensive chemotherapy, but older adults often tolerate therapy poorly, and prognosis worsens significantly with age.

Asset Subtitle

Hari R. Nair

Meta Tag

Author List Hari R. Nair, Monica Thim

Category Clinical Vignettes

Concept Burkitt Lymphoma

Concept t814 Translocation

Concept Tumor Lysis Syndrome

Concept Sporadic Burkitt Lymphoma

Concept MYC

Distinguished Non-Finalist

Presenter Organization University of New England College of Osteopathic Medicine

Presenting Author Hari R. Nair

Track Adult

Keywords

Burkitt lymphoma

B-cell non-Hodgkin lymphoma

tumor lysis syndrome

abdominal mass

ascites

MYC translocation

t(8;14)

lymphadenopathy

Ki-67 proliferation index

older adult

Burkitt Lymphoma

t814 Translocation

Tumor Lysis Syndrome

Sporadic Burkitt Lymphoma

MYC