Abstract
IntroductionBurkitt’s lymphoma is a highly aggressive lymphoma. The endemic form is present with Epstein - Barr virus. The most common sites are the mandible, facial bones, kidneys, gastrointestinal tract, ovaries, breast and extra-nodal sites. We present the first reported case of a primary Burkitt’s lymphoma of the postnasal space occurring in an elderly Caucasian male.Case presentationA 72-year-old Caucasian male farmer presented with a 6-week history of a productive cough and a painless left sided cervical swelling. Examination of the neck revealed a 5 cm by 5 cm hard mass in the left anterior triangle. A CT scan of the head and neck showed a soft tissue swelling in the postnasal space. Histology of the postnasal space mass showed squamous mucosa infiltrated by a high grade lymphoma.Immunohistochemical staining and in situ hybridisation confirmed the tumour to be Epstein - Barr virus Ribonucleic acid negative suggesting this was a rare sporadic form of the tumour presenting in a location that is atypical for the clinical subtype and age of the patient.ConclusionThis is the first reported case of sporadic Burkitt’s lymphoma of the postnasal space of an elderly Caucasian male in the absence of Epstein - Barr virus or human immunodeficiency virus infection and further serves to illustrate the diversity of histological subtypes of malignancies that may develop at this concealed site.
Highlights
Burkitt’s lymphoma is a highly aggressive lymphoma
The endemic form is present with Epstein - Barr virus (EBV) in most cases
We present the first reported case of a primary Burkitt’s lymphoma of the postnasal space occurring in an elderly Caucasian male
Summary
Burkitt’s lymphoma is a highly aggressive lymphoma that appears to occur in three histologically and phenotypically identical but clinically distinct forms; endemic, sporadic and immunodeficiency-associated. Immunohistochemical staining and in situ hybridisation for Epstein - Barr virus (EBV) revealed the tumour to be EBV Ribonucleic acid (RNA) negative, EBNA2 (monoclonal) negative and LMP1 (monoclonal) negative, confirming there was no previous infection with the Figure 2 Computed tomography scan showing a well circumscribed lymph node in the left side of the neck. This is the first reported case of sporadic Burkitt’s lymphoma of the postnasal space of an elderly Caucasian male in the absence of EBV or HIV infection and further serves to illustrate the diversity of histological subtypes of malignancies that may develop at this concealed site. The patient was treated with a CODOX-M chemotherapy regime (Cyclophosphamide 350 mg Day 2–5, Cytarabine 70 mg IT DI, 3, Methotrxate 3 g/m2 DIO with folinic acid rescue) and remains in remission after five years
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