Virender Suhag, Sunita, Subhash Singh, Vinod Kumar Nimbrian, Ashwani Dalal.
Ileocaecal Burkitt`s Lymphoma in a 14 year old male: a case report and review of literature.
Pak J Med Sci Jan ;21(1):78-81.

A 14 year old boy presented with the main complaint of pain in the abdomen, mainly in supra-umbilical region of 25 days duration, constipation for the last 20 days, vomiting for the past 2 weeks, loss of appetite for the last 10 days and abdominal distension for the last 5 days and inability to pass stools and flatus for the last 2 days. All these symptoms were progressively increasing in intensity. There was no history of fever, significant loss of weight or of altered bowel habits. There was no effect of oral medication on these symptoms. On examination, the general condition of the patient was fair. There was no pallor, pedal edema or significant LAP. On per abdominal examination, there was no tenderness and no guarding. Per rectal examination was within normal limits. When investigated, the complete hemogram, biochemical profile, chest X-ray and serum LDH were essentially normal. On abdominal USG, there was no free fluid in the abdomen. Few fluid filled bowel loops were seen. CT scan revealed mass lesion in ileocaecum with diffuse thickening of bowel wall. Pre-operative diagnosis of subacute intestinal obstruction was made. At surgical exploration, there was an iliocaecal lump causing near-complete obstruction. Mesenteric LAP was present. The patient underwent iliocaecal resection, ilioascending end to end anastomosis and local peritoneal lavage. Histopathological examination of the resected ileocaecal segment of gut revealed Non Hodgkin`s Lymphoma, high grade Burkitts type. The isolated lymph nodes were free of tumor infiltration. Bone marrow aspiration and trephine was essentially normal. The patient was put on combination chemotherapy with COP regimen (Inj Cyclophosphamide, Inj Vincristine and Tab Prednisolone) two weeks post-operatively, with frequent monitoring of biochemical parameters of tumor lysis syndrome. He has received three courses so far and is asymptomatic.

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