Abstract

Acute pancreatitis in children is usually due to infection, trauma, or anatomical abnormalities and is rarely due to obstruction from malignancy. Sporadic Burkitt lymphoma (BL) is an aggressive non-Hodgkin B-cell lymphoma that usually involves the bowel or pelvis, with isolated cases presenting as acute pancreatitis. We report a case of BL in a 12-year-old male presenting as acute pancreatitis with obstructive jaundice and a right middle cranial fossa mass invading the sphenoid bone. The common bile duct in this case was dilated to 21 mm in diameter on abdominal ultrasound and to 26 mm on magnetic resonance cholangiopancreatography (MRCP), significantly greater than any value reported in the literature for BL. Given the rapidly progressing nature of BL, we emphasize the importance of recognizing heterogeneous presentations of this disease to improve patient survival. We also conclude that it is important to consider malignancy in a child with acute pancreatitis, particularly in the presence of obstructive jaundice or multisystem involvement. Other Presentations. This case report has no prior publications apart from the abstract being accepted to the 2020 SIOP (International Society of Pediatric Oncology) meeting and 2020 ASPHO conference (canceled due to the COVID-19 pandemic) and subsequently published as an abstract only in Pediatric Blood and Cancer. We have also presented the abstract as a poster presentation at our institution's (NYU Langone Hospital—Long Island, previously known as NYU Winthrop) annual research day conference in 2020.

Highlights

  • Acute pancreatitis in children is mostly due to infection, trauma, anatomical abnormalities, or medications and is rarely due to obstruction from malignancy [1]

  • We describe a case of a twelve-year-old boy who presented with severe pancreatitis associated with obstructive jaundice and a middle cranial fossa mass invading the sphenoid bone, who was diagnosed with Burkitt’s lymphoma

  • The sporadic form of Burkitt’s lymphoma (BL) seen in North America, Europe, and East Asia has a relatively low annual incidence of 2 per million children under the age of 18, the annual incidence of endemic BL is estimated to be 40–50 per million in children less than 18 [4]

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Summary

Introduction

Acute pancreatitis in children is mostly due to infection, trauma, anatomical abnormalities, or medications and is rarely due to obstruction from malignancy [1]. Few cases of non-Hodgkin lymphoma in adults and even less in children have been reported to cause acute pancreatitis with obstructive jaundice through invasion of the head of the pancreas and compression of the pancreatic and common bile ducts [1, 2]. Burkitt’s lymphoma (BL) is an aggressive rapidly dividing non-Hodgkin B-cell lymphoma that often presents with extranodal masses It comes in three variants—endemic, sporadic, and immunodeficiency-associated subtypes. The common bile duct (CBD) was dilated up to 2.6 cm on magnetic resonance cholangiopancreatography (MRCP), significantly higher than any value reported in the literature for Burkitt’s lymphoma. This case highlights the importance of considering malignancy in a child with acute pancreatitis, especially in the presence of multisystem involvement

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