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Orbital Burkitt's Lymphoma

Burkitt's Lymphoma of Orbit


Presentation

  • A case of maxillary sporadic BL (sBL) associated with neuro-orbital involvement in an Indian male is presented. sBL initially presented as maxillary swelling with no obvious dental and periodontal changes.[contempclindent.org]
  • Non-African Burkitt lymphoma presenting with oral thrush and an orbital mass in a child. Arch Ophthalmol 1998; 124 :859–61.[nature.com]
  • We report a case of histopathologically confirmed non-African Burkitt's lymphoma with a rare presentation in an immunocompetent patient.[healio.com]
  • The sporadic form usually presents with abdominal findings. It is rare in adults, making up less than 1% of non‐Hodgkin's lymphomas. Typical age of presentation is less than 35 years.[shmabstracts.com]
  • At the time of presentation, signs and symptoms depend on the site and degree of involvement, the stage of the malignancy and the histological subtype of the disease.[ijmpo.org]
Physician
  • However, even in those countries in which paediatric cancer is attracting increasing interest, the disease is relatively uncommon, and the number of cases seen by anyone physician, even in a large general hospital, is often limited to one or two a year[books.google.com]
  • The specific code assignment depends on the cell type as documented by the physician.[fortherecordmag.com]
  • Samer A Bleibel, MD Staff Physician, Department of Internal Medicine, Wayne State University School of Medicine, St John's Hospital and Medical Centers Samer A Bleibel, MD is a member of the following medical societies: American College of Physicians[emedicine.medscape.com]
  • However, this regimen requires treating physicians to adjust the doxorubicin, etoposide and cyclophosphamide doses based on neutrophil and platelet nadirs with each cycle.[cancertherapyadvisor.com]
Candidiasis
  • 2018 2019 Billable/Specific Code Manifestation Code Applicable To Pyelonephritis Tubulo-interstitial nephritis Type 1 Excludes diphtheritic pyelonephritis and tubulo-interstitial nephritis ( A36.84 ) pyelonephritis and tubulo-interstitial nephritis in candidiasis[icd10data.com]
  • Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. N Eng J Med 1981;305:1425-3l. Masur H, Michelis MA, Greene JB, et al.[cdc.gov]
Asymptomatic
  • Chemotherapy led to complete and asymptomatic remission of the cavernous sinuses lesions. The disease had a highly aggressive course and the patient died 11 months after diagnosis.[ibimapublishing.com]
Splenomegaly
  • All patients had generalized lymphadenopathy, and 3 had splenomegaly of uncertain duration. Detailed virology and immunology studies are in progress.[cdc.gov]
Hepatomegaly
  • A systemic examination revealed a 2-cm hepatomegaly. He had no other pathologic systemic signs. Abdominal ultrasonography and computed tomography revealed enlarged abdominal retroperitoneal lymph nodes and hepatomegaly.[healio.com]
Periodontitis
  • A case of maxillary sporadic BL (sBL) associated with neuro-orbital involvement in an Indian male is presented. sBL initially presented as maxillary swelling with no obvious dental and periodontal changes.[contempclindent.org]
Back Pain
  • Pain 224 Physical Examination 225 Radiological Findings 226 Minimally Invasive Approaches Diagnostic Procedures for Low Back Pain 227 Medial Branch Blocks 230 Minimally Invasive Approaches Diagnostic Procedures for Leg Pain 231 TransForaminal Diagnostic[books.google.com]
  • Secondary deposits in the spine cause intractable back pain. Abdominal pain Patients with extranodal involvement can have intra-abdominal mass.[explainmedicine.com]
Leg Pain
  • Pain 231 TransForaminal Diagnostic Injections 232 Minimally Invasive Treatments for Low Back Pain 234 IntraDiscalElectroTherapy IDET 235 Medial Branch RadioFrequency Lesionning 236 Minimally Invasive Treatments for Leg Pain 237 Percutaneous Epidural[books.google.com]
Low Back Pain
  • Back Pain 224 Physical Examination 225 Radiological Findings 226 Minimally Invasive Approaches Diagnostic Procedures for Low Back Pain 227 Medial Branch Blocks 230 Minimally Invasive Approaches Diagnostic Procedures for Leg Pain 231 TransForaminal Diagnostic[books.google.com]
Diplopia
  • Four weeks later, patient presented with orbital involvement as diplopia, sixth cranial nerve palsy, and medial rectus palsy. Chemotherapy regimen according to LMB 89 protocol was started.[contempclindent.org]
  • Three months after the initiation of chemotherapy, strabismus and diplopia had resolved, and proptosis markedly decreased, although there was no change in her BCVA.[bmcophthalmol.biomedcentral.com]
  • RESULTS: A 66 year old male presented to the Accident and Emergency department with a 36 hour history of diplopia on waking, left retro-orbital pain and neck ache. On admission he had evidence of partial bilateral abducens nerve palsies.[neurology.org]
  • Although diplopia and ocular palsies have been previously reported in patient with BL, rarely bilateral cavernous syndrome is the initial manifestation in immunocompetent adults.[ibimapublishing.com]
  • Other symptoms include double vision (diplopia), and pupillary abnormalities. The associated lid dysfunction and incomplete lid closure (lagophthalmos) or lacrimal gland dysfunction can result in exposure keratopathy, keratitis, and ocular pain.[skullbaseinstitute.com]
Chemosis
  • An ocular examination disclosed severe nonaxial proptosis with inferotemporal displacement of the globe, Chemosis, and restricted motility in the right eye. A firm mass was palpable superior to the globe.[healio.com]
  • […] disease. [5,6] Intra-oral lesions Although rare, some patients' initial presentation of BL can be intra-oral mass, which is preceded by toothache and loosening of tooth. [8] Symptoms of orbital mass BL can present with painless ptosis, orbital mass and chemosis[explainmedicine.com]
  • External examination demonstrated proptosis, soft tissue swelling in the upper and lower lids, and scleral “show” with mild conjunctival injection and chemosis in the right eye (Figure 1).[djo.harvard.edu]
  • Ophthalmic examination revealed right upper and lower lid edema with marked proptosis and chemosis of the right eye. Cornea showed exposure keratitis.[ccij-online.org]
Strabismus
  • Three months after the initiation of chemotherapy, strabismus and diplopia had resolved, and proptosis markedly decreased, although there was no change in her BCVA.[bmcophthalmol.biomedcentral.com]
  • […] see also Systemic Diseases) Trauma (Injury), Toxic Keratopathies, Radiation Tumors, Neoplasma Glaucomas, Ocular Hypertension Hypertensive Retinopathy Iris and Ciliary Body Lacrimal System Lens Lids Neuro-Ophthalmology Optic Nerve Orbit Retina Sclera Strabismus[atlasophthalmology.net]
Unilateral Proptosis
  • Symptoms Orbital tumors typically present with early unilateral proptosis of the globe and may adversely affect visual and extraocular muscle function. Other symptoms include double vision (diplopia), and pupillary abnormalities.[skullbaseinstitute.com]
  • This report describes the case of a 14-year-old boy who presented with rapidly progressive unilateral proptosis which was found to be round cell tumor on histopathology.[ccij-online.org]
Facial Swelling
  • If the tumor is in the head and neck region, the patient may have symptoms of nasal obstruction, rhinorrhea, facial swelling, ophthalmic involvement, tonsillar enlargement, and cervical lymphadenopathy.[czytelniamedyczna.pl]
Numb Chin Syndrome
  • Vasconcelos Seixasa D, Lobob AL, Farinhab NJ et al: Burkitt leukemia with numb chin syndrome and cavernous sinus involvement. Eur J Pediatr Neurol 2006; 10: 145-147. 11.[czytelniamedyczna.pl]
Cranial Nerve Involvement
  • Burkitt's lymphoma with cranial nerve involvement. Arch Ophthalmol 1980; 98 :2015–17. 7. Weisenthal RW, Streeten BW, Dubansky AS, Hutchison RE, Pecora JL. Burkitt lymphoma presenting as a conjunctival mass. Ophthalmology 1995; 102 :129–34. 8.[nature.com]
  • Trese MT, Krohel GB, Hepler RS, Naeim F: Burkitt's lymphoma with cranial nerve involvement. Arch Ophthalmol 1980;98:2015-2017. Coupland SE, Krause L, Delecluse HJ, et al: Lymphoproliferative lesions of the ocular adnexa. Analysis of 112 cases.[karger.com]
Peripheral Neuropathy
  • neuropathy syndrome Leigh-like encephalopathy-optic atrophy-peripheral neuropathy syndrome Leigh necrotizing encephalopathy due to pyruvate carboxylase deficiency Leigh syndrome Leigh syndrome due to PC deficiency Leigh syndrome due to pyruvate carboxylase[orpha.net]

Workup

  • The large number of patients with central nervous system involvement in our review of the literature supports the role of lumbar puncture and neuroimaging in the workup of all patients with orbital Burkitt lymphoma.[ncbi.nlm.nih.gov]
  • Further systemic workup was performed for BL. Cytogenetic analysis did not show aneusomy or Myc rearrangement in 200 of 200 interphase nuclei.[karger.com]
  • Expedite the staging workup. A diagnosis can sometimes be made by bone marrow aspiration and biopsy if the marrow is involved. If the marrow is not involved, diagnosis will require sampling lymph nodes or the involved extranodal site.[emedicine.medscape.com]
  • Imaging procedure such as computed tomography and magnetic resonance imaging can help determine the extent of the primary disease, and a total body disease workup should include positron emission tomography and evaluation of the bone marrow and cerebrospinal[czytelniamedyczna.pl]

Treatment

  • […] for Low Back Pain 234 IntraDiscalElectroTherapy IDET 235 Medial Branch RadioFrequency Lesionning 236 Minimally Invasive Treatments for Leg Pain 237 Percutaneous Epidural Neuroplasty Racz Procedure and Epiduroscopy 238 Spinal Cord Stimulation 239 Intrathecal[books.google.com]
  • The patient after 5 days of treatment.[healio.com]
  • For more information about the treatment options described here, see the Treatment Options section.[cancer.net]
  • A heterogenous thickening seen in the right maxillary sinus (three months after treatment) Figure 4. A mild thickness in the right maxillary sinus (six months after treatment) Figure 5.[pubs.sciepub.com]

Prognosis

  • Involvement of the central nervous system and bone marrow is indicative of a poor prognosis.[healio.com]
  • Treatment and prognosis Prognosis depends on stage as well as several other factors such as age, serological markers (ESR), presence of B symptoms, and histological tumor subtype: nodular lymphocyte predominant: best prognosis lymphocyte depleted: worse[radiopaedia.org]
  • Review results of the six adult orbital sBL cases support a poor prognosis and a heightened suspicion of variant CD10, CD20 and BCL6 positive sBL in adults presenting with jaw pain and rapidly progressive orbital symptoms, particularly in female, African[dovepress.com]
  • Prognosis remains guarded, with significant mortality within 1 year of presentation.[ncbi.nlm.nih.gov]
  • Both hodgkin and non-hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer.[icd10data.com]

Etiology

  • Etiology In most cases Burkitt lymphoma is associated with a specific translocation t(8;14)(q24;q32) that juxtaposes the MYC/c-Myc gene (8q24) next to the heavy chain immunoglobulin gene (14q32).[orpha.net]
  • Diagnosis Evaluation of a patient with a presumed orbital mass begins with a thorough ophthalmic and medical history including history of allergies, sinus infections, recent trauma to rule out all non-neoplastic sinonasal etiologies for the disease process.It[skullbaseinstitute.com]
  • More rarely, an infectious etiology should also be considered.[djo.harvard.edu]
  • In endemic areas, there seems to be a correlation with the geographic distribution of endemic malaria. [22, 23] (See Etiology and Pathophysiology.) Although no racial predilection is reported, there is a sex and age predilection.[emedicine.medscape.com]
  • Burkitt DP (1969) Etiology of Burkitt's lymphoma—an alternative hypothesis to a vectored virus J Natl Cancer Inst 42 19–28 PMID: 4303830 30.[ecancer.org]

Epidemiology

  • In: Cancer Epidemiology and Prevention. M Schottenfeld, JF Fraumeni, eds, WB Saunders, Philadelphia 1982:754-78. National Cancer Institute. Surveillance epidemiology end results. Incidence and mortality data: 1973-1977. Monograph 57. U.S.[cdc.gov]
  • […] media repository Jump to navigation Jump to search Radiology : Ultrasound · X-ray · Computed tomography · Magnetic resonance · Positron emission tomography · Bone scintigraphy Anatomical pathology : Gross pathology · Histopathology Other : Endoscopy · Epidemiology[commons.wikimedia.org]
  • .  Introduction Definition Epidemiology Aetiology Clinical Features Investigations Staging Treatment Prognosis 3.  Lymphomas are malignant proliferation of the lymphoid tissue2 broad classification: Hodgkin’s d’se and Non-Hodgkin’s lymphoma[slideshare.net]
  • Wright GH (1967) The epidemiology of Burkitt’s tumor. Cancer Res 27, pt 1: 2424–2438 PubMed Google Scholar 12. Ziegler L (1977) Treatment results of 54 American patients with Burkitt’s lymphoma are similar to the African experience.[link.springer.com]
  • Burkitt lymphoma has provided a model for the understanding of the epidemiology, the molecular abnormalities that induce tumours and the treatment of other lymphomas.[ecancer.org]
Sex distribution
Age distribution

Pathophysiology

  • […] and pathophysiologic mechanisms leading to the development of Burkitt lymphoma are not known.[emedicine.medscape.com]

Prevention

  • To prevent tumor lysis, some groups prefer to give an initial low dose "cytoreductive" treatment followed by more intensive chemotherapy.5 The prognosis for this disease is directly related to tumor burden.[healio.com]
  • Lymphoma cause, prevention and treatment of lymphoma with herbs, vitamins, supplements, and natural diet options January 2 2016 by Ray Sahelian, M.D.[raysahelian.com]
  • Radiotherapy,BL is a radio-sensitive tumour but b’se of it’s rapid growth, radiotherapy is ineffectiveTumour regrows btn @ day’s therapyProphylactic craniospinal irradiation achieved no results in preventing or delaying CNS relapse 28.  ANY QUESTIONS[slideshare.net]
  • In: Cancer Epidemiology and Prevention. M Schottenfeld, JF Fraumeni, eds, WB Saunders, Philadelphia 1982:754-78. National Cancer Institute. Surveillance epidemiology end results. Incidence and mortality data: 1973-1977. Monograph 57. U.S.[cdc.gov]

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