824 THE VARYING CLINICAL SPECTRUM OF PRESENTATION OF BURKITT'S LYMPHOMA IN CHILDREN

Abstract

Burkitt's lymphoma is a rare neoplasm in children and has varied clinical presentations and course. Six Caucasion children between the ages of 5 and 18 years were studied at Henry Ford Hospital. Five were male and one was female. Five out of six of the patients were initially diagnosed as having gastroenteritis. Their initial presentation was abdominal pain, vomiting and distention. Two of the children had evidence of acute intestinal obstruction at the time of diagnosis. Leukemic transformation (4/6), meningeal involvement (3/6), testicular involvement (1/6), bilateral ovarian involvement with ascites and hypomenorrhea (1/6), monarticular arthritis with bone involvement (1/6), massive pleural effusion (1/6), submandibular lymphadenopathy (1/6) were other clinical signs present at the time of diagnosis. Two out of six achieved complete remission on chemotherapy and are long-term survivors at 70 months and 66 months. Serum lactic dehydrogenase (LDH) levels closely correlated with recurrence and extent of tumor mass. Both patients who had complete remissions had only localized disease and had LDH levels below 400 IU/cc. Metabolic complications encountered consisted of uric acid nephropathy (1), hypocalcemia and hyperphosphatemia (2) with uncontrolled seizures. Morphological, cytochemical and ultrastructural studies were performed to confirm the pathological diagnosis.