A Life-Saving Early Diagnosis of Burkitt Lymphoma Involving both Jaws, Misdiagnosed as Pericoronitis

Abstract

Purpose: Burkitt lymphoma (BL) is a highly aggressive and rare B-cell non-Hodgkin’s lymphoma. In this paper, a rare case of BL, involving both jaws, was presented. Case Report: A 24-year-old male patient was referred to our clinic with the complaint of mandibular and maxillary swelling for two months. He was previously misdiagnosed with pericoronitis and had a history of right mandibular third molar tooth extraction, one-month prior. Intraoral examination showed swelling, ulceration, and spontaneous bleeding in both jaws. Radiographically, extensive osteolytic lesions, irregular periodontal space widening, loss of lamina dura, and peri-radicular radiolucencies were detected. Incisional biopsy was performed from both jaws and the final diagnosis was made as BL. Conclusion: It is crucial to be aware of the clinical and radiological features of this disease by dentists and to consult the attending physician without delay.

Keywords

• Burkitt’s lymphoma
• Non-Hodgkin’s lymphoma
• oral cavity
• jaws
• mandible

References

1. Müller AMS, Ihorst G, Mertelsmann R, Engelhardt M. Epidemiology of non-Hodgkin’s lymphoma (NHL): Trends, geographic distribution, and etiology. Ann Hematol 2005; 84:1-12.
2. Siqueira JM, Fernandes PM, Oliviera ACF, Vassallo J, Abreu AF, Jaguar GC. Primary diffuse large B-cell lymphoma of the mandible. Autops Case Rep (São Paulo) 2019; 9: e2019109.
3. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68:394-424.
4. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69:7-34.
5. Wolvius EB, van der Valk P, van der Wal JE, et al. Primary extranodal non-Hodgkin lymphoma of the oral cavity. An analysis of 34 cases. Eur J Cancer B Oral Oncol 1994; 30:121-125.
6. White SC, Pharoah MJ. Oral Radiology. Principles and Interpretation. 7th ed. St. Louis, Missouri: Elsevier; 2014.
7. Pereira DL, Fernandes DT, Santos-Silva AR, Vargas PA, De Almeida OP, Lopes MA. Intraosseous non-Hodgkin lymphoma mimicking a periapical lesion. J Endod 2015; 41:1738-1742.
8. Linch DC. Burkitt lymphoma in adults. Br J Haematol 2012; 156:693-703.

9. Graham BS, Lynch DT. Burkitt Lymphoma. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2021.
10. Dozzo M, Carobolante F, Donisi PM, et al. Burkitt lymphoma in adolescents and young adults: management challenges. Adolesc Health Med Ther 2016; 8:11-29.
11. Crombie J, LaCasce A. The treatment of Burkitt lymphoma in adults. Blood 2021; 137:743-750.
12. Kemp S, Gallagher G, Kabani S, Noonan V, O’Hara C. Oral non-Hodgkin’s lymphoma: review of the literature and World Health Organization classification with reference to 40 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105:194-201.
13. Jessri M, Majeed AA, Matias M, Farah C. A case of primary diffuse large B-cell non-Hodgkin’s lymphoma misdiagnosed as chronic periapical periodontitis. Aust Dent J 2013; 58:250-255.
14. Okahata R, Shimamoto H, Marutani K, et al. Diffuse large B-cell lymphoma of the mandible with periosteal reaction: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:228-222.
15. Kini R, Saha A, Naik V. Diffuse large B-cell lymphoma of mandible: a case report. Med Oral Patol Oral Cir Bucal 2009; 14:421-424.
16. Buchanan A, Kalathingal S, Capes J, Kurago Z. Unusual presentation of extranodal diffuse large B-cell lymphoma in the head and neck: description of a case with emphasis on radiographic features and review of the literature. Dentomaxillofac Radiol 2015; 44:20140288.
17. Vega F, Lin P, Medeiros LJ. Extranodal lymphomas of the head and neck. Ann Diagn Pathol 2005; 9:340-350.
18. Malik AH, Shah AA, Latoo S. B-cell lymphoma mimicking pericoronitis. Egypt J Oral Maxillofac Surg 2013; 4:15-7.
19. Gouveia MH, Otim I, Ogwang MD, et al. Endemic Burkitt Lymphoma in second-degree relatives in Northern Uganda: in-depth genome-wide analysis suggests clues about genetic susceptibility. Leukemia 2021; 35:1209-1213.