Burkitt Lymphoma of the Appendix with an Insidious Clinical Picture

Abstract

Burkitt lymphoma (BL) is a highly aggressive B cell non-Hodgkin lymphoma, which represents the fastest growing human tumor with doubling time as short as 25 hours. Three distinct clinical forms of BL have been described: endemic, sporadic, and immunodeficiency-associated. Although the sporadic form of Burkitt lymphoma usually has an abdominal presentation, with ascites and large masses in the distal ileum, primary infiltration of the appendix is rare. Even in these cases, the clinical picture resembles that of acute appendicitis. We present here the case of a patient with sporadic Burkitt lymphoma of the appendix whose only presenting symptom was scrotal pain. After thorough imaging evaluation, the inconsistency between clinical-laboratory and radiological findings prompted exploratory laparoscopy. The patient underwent laparoscopic appendectomy and omental biopsy. Final diagnosis was made based on histopathology of surgical specimen. To the best of our knowledge, this is the first report of primary BL of the appendix presenting without typical symptoms and signs of acute appendicitis.