Mehmet Ali ERDOGAN, Oguzhan YİLDİRİM, Yuksel SECKİN, Hale KİRİMLİOGLU, Yahya ATAYAN, Yasir Furkan CAGİN, Melda OZKAN COMERT, Yilmaz BİLGİC, Ismet AYDOGDU

Ascites and hepatic involvement: a rare and atypical presentation of Burkitt Lymphoma

Burkitt lenfoma (BL), erişkinlerdeki lenfomanın sık olmayan formlarından biridir. Bu hastalıkta omentum ve peritonun yaygın tutulumu nadirdir. Burkit lenfomanın nadir ve gözden kaçmış klinik sunumu ile gelen bu assitli olguyu sunuyoruz. Daha önce herhangi bir hastalığı olmayan sağlıklı, 20 yaşındaki erkek hasta, karın ağrısı, şişkinlik ve gece terlemesi şikayetleri ile hastanemize başvurdu. Fizik muayenesinde assiti mevcut idi. Bilgisayarlı tomografide karaciğerde metastaz ile uyumlu lezyonlar ve asit izlenirken patolojik herhangi bir torakal ve abdominal lenfadenopati rapor edilmedi. Assit mayi sitolojisinde stoplazmik vakouller içeren atipik lenfositler izlendi. Kemik iliği aspirasyonunda yıldızlı gökyüzü manzarası gözlendi. İmmunofenotipinde CD20 pozitif iken, CD30, CD79a/Tdt negatif görüldü. Assitli, lenfadenopatisiz karaciğer veya fokal gastrointestinal kitlesi olan genç hastalarda Burkitt lenfoması düşünülmesi gerekir. Burkitt lenfoma; lenfadenopati veya fokal gastrointestinal kitleler olmadan bile assit ve karaciğerde kitle ile başvuran genç hastalarda düşünülmelidir.

Burkitt lenfoma'nın asit ve karaciğer tutulumunun olduğu, nadir görülen atipik prezentasyonu

Burkitt lymphoma (BL) is an uncommon form of lymphoma in adults. In this disease, extensive involvement of the omentum and the peritoneum is rare. We present this case with ascites because it is such a rare and overlooked clinical presentation of BL. A previously healthy 20-year-old man was admitted to our hospital with abdominal pain, distension, and night sweats. Physical examination revealed massive ascites. Computerized tomography showed liver metastasis and ascites, but no pathologic thoracal or abdominal lympadenopathy was reported. Atypical lymphocytic cells with cytoplasmic vacuoles were determined on cytologic examination of ascites. We detected starry sky view on the bone marrow examination. On immunophenotyping, cells were CD20 positive, but negative for CD30, CD79a/Tdt. Patient was diagnosed as BL. Burkitt lymphoma should be considered in young patients presenting with ascites and hepatic mass even without lymphadenopathy or focal gastrointestinal masses.

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