Burkitt's lymphoma is a highly aggressive, mature B cell non-Hodgkin's lymphoma that is rare outside Africa. We report a case of Burkitt's lymphoma presenting as a rapidly expanding tongue-base mass that caused airway obstruction in an 80-year-old Palestinian man living in California. According to our review of the literature, this is only the third reported case of Burkitt's lymphoma arising in the base of the tongue. We also discuss the incidence, epidemiology, genetics, prognosis, and treatment of this malignancy. Because Burkitt's lymphoma is one of the fastest-growing tumors in humans, rapid diagnosis and treatment are important. Treatment involves brief-duration, high-intensity chemotherapy and central nervous system prophylaxis. It is important for the otolaryngologist to recognize this disease and to understand the steps necessary to treat this aggressive tumor.
References
1.
ManolopoulosL, NikolopoulosTP, YiotakisJ, . Burkitt's lymphoma in the base of the tongue: Differential diagnosis and management. ORL J Otorhinolaryngol Relat Spec2003;65:226–9.
BernsteinJI, ColemanCN, StricklerJG, . Combined modality therapy for adults with small noncleaved cell lymphoma (Burkitt's and non-Burkitt's types). J Clin Oncol1986;4:847–58.
4.
MillerTP, DahlbergS, CassadyJR, . Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high–grade non-Hodgkin's lymphoma. N Engl J Med1998;339:21–6.
BurkittD.A sarcoma involving the jaws in African children. Br J Surg1958;46:218–23.
7.
OyetunjiNM, LadapoAA.Burkitt's lymphoma of the mastoid temporal bone. J Laryngol Otol1981;95:1063–7.
8.
HarrisNL, JaffeES, SteinH, . A revised European-American classification of lymphoid neoplasms: A proposal from the International Lymphoma Study Group. Blood1994;84:1361–92.
9.
JaffeES, HarrisNL, SteinH, VardimanJW, eds. Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. Lyon: IARC Press; 2001.
10.
HarrisNL, JaffeES, DieboldJ, . The World Health Organization Classification of neoplasms of the hematopoietic and lymphoid tissues: Report of the Clinical Advisory Committee meeting—Airlie House, Virginia, November 1997. Hematol J2000;1:53–66.
11.
BlumKA, LozanskiG, ByrdJC.Adult Burkitt leukemia and lymphoma. Blood2004;104:3009–20.
12.
HechtJL, AsterJC.Molecular biology of Burkitt's lymphoma. J Clin Oncol2000;18:3707–21.
13.
KnudsonAJr.Genetics of tumors of the head and neck. Arch Otolaryngol Head Neck Surg1993;119:735–7.
14.
EpsteinMA, AchongBG, BarrYM.Virus particles in cultured lymphoblasts from Burkitt's lymphoma. Lancet1964;15:702–3.
15.
ZieglerJL.Burkitt's lymphoma. N Engl J Med1981;305:735–45.
16.
Thorley-LawsonDA, GrossA.Persistence of the Epstein-Barr virus and the origins of associated lymphomas. N Engl J Med2004; 350:1328–37.
17.
KennedyG, KomanoJ, SugdenB.Epstein-Barr virus provides a survival factor to Burkitt's lymphomas. Proc Natl Acad Sci U S A2003;100:14269–74.
18.
BurkittD.Malignant lymphomata involving the jaws in Africa. J Laryngol Otol1965;79:929–39.
19.
LevinePH, KamarajuLS, ConnellyRR, . The American Burkitt's Lymphoma Registry: Eight years’ experience. Cancer1982;49:1016–22.
20.
WangMB, StrasnickB, ZimmermanMC.Extranodal American Burkitt's lymphoma of the head and neck. Arch Otolaryngol Head Neck Surg1992;118:193–9.
21.
BauerGP, VolkMS, SiddiquiSY, . Burkitt's lymphoma of the parapharyngeal space. Arch Otolaryngol Head Neck Surg1993; 119:117–20.
22.
AnaviY, KaplinskyC, CalderonS, ZaizovR.Head, neck, and maxillofacial childhood Burkitt's lymphoma: A retrospective analysis of 31 patients. J Oral Maxillofac Surg1990;48:708–13.
23.
BanthiaV, JenA, KackerA.Sporadic Burkitt's lymphoma of the head and neck in the pediatric population. Int J Pediatr Otorhinolaryngol2003;67:59–65.
24.
WellingDB, McCabeBF.American Burkitt's lymphoma of the mastoid. Laryngoscope1987;97:1038–42.
VinayakBC, ReddyKT, FultonJ, MilfordCA.Pediatric nonendemic Burkitt's lymphoma of the head and neck. Ann Otol Rhinol Laryngol1994;103:238–40.
27.
DavidSS.Burkitt's lymphoma of the nasopharynx. J Laryngol Otol1972;86:387–93.
28.
AbazaNA, IczkovitzML, HeneferEP.American Burkitt's lymphoma manifested in a solitary submandibular lymph node. Oral Surg Oral Med Oral Pathol1981;51:121–7.
29.
MarcusenDC, SooyCD.Otolaryngologic and head and neck manifestations of acquired immunodeficiency syndrome (AIDS). Laryngoscope1985;95:401–5.
30.
DaviF, DelecluseHJ, GuietP, . Burkitt-like lymphomas in AIDS patients: Characterization within a series of 103 human immunodeficiency virus-associated non-Hodgkin's lymphomas. Burkitt's Lymphoma Study Group. J Clin Oncol1998;16:3788–95.
31.
MurphySB.Childhood non-Hodgkin's lymphoma. N Engl J Med1978;299:1446–8.
32.
CarbonePP, KaplanHS, MusshoffK, . Report of the Committee on Hodgkin's Disease Staging Classification. Cancer Res1971;31:1860–1.
33.
ShippMA.Prognostic factors in aggressive non-Hodgkin's lymphoma: Who has “high risk” disease?Blood1994;83:1165–73.
34.
CoiffierB, LepageE, BriereJ, . CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med2002;346:235–42.
35.
AnaissieE, GehaS, AllamC, . Burkitt's lymphoma in the Middle East. A study of 34 cases. Cancer1985;56:2539–43.
36.
ArdekianL, RachmielA, RosenD, . Burkitt's lymphoma of the oral cavity in Israel. J Craniomaxillofac Surg1999;27:294–7.
