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Melena: a rare presentation of childhood Burkitt's lymphoma
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Melena: a rare presentation of childhood Burkitt's lymphoma
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Journal Article
Melena: a rare presentation of childhood Burkitt's lymphoma
2005
Overview
Non-Hodgkin's lymphoma and Hodgkin's lymphoma constitute 60% and 40% respectively of the pediatric lymphomas, which are the third most common type of malignant disease in North American children.2 [Burkitt]'s lymphoma is the most common subtype of non-Hodgkin's lymphoma, with an incidence of 2 cases per million children in North America (sporadic variety) and up to 100 cases per million children in equatorial Africa (endemic variety).3 It is believed that the Epstein-Barr virus plays a causal role, particularly in Africa. Burkitt's lymphoma is characterized by a clonal proliferation of relatively mature B cells, and the majority of cases contain a chromosomal translocation - t(8;14) - that leads to uncontrolled expression of a proto-oncogene. Endemic Burkitt's lymphoma has a peak incidence among children 11 years old, usually presenting with the classic jaw tumour and occasionally involving the gastrointestinal tract and kidneys. This is in contrast to the sporadic type, whose peak incidence is among children 7 years old and whose presentation largely involves the gastrointestinal tract. This results from direct involvement of Peyer's patches, and affected children commonly present with an abdominal mass or pain, distendon, nausea and vomiting. Intussusception, obstruction or perforation may occur.4 However, presentation with bleeding in the upper gastrointestinal tract, as in the case we have described, has not been previously reported to our knowledge. Other common potential sites affected by the sporadic form of Burkitt's lymphoma include tonsils or adenoids, bone marrow, bone, kidneys, testes, the central nervous system and salivary glands. Both forms of Burkitt's lymphoma occur more often in boys than in girls, at a ratio of 2-3:1.
Publisher
CMA Impact Inc,CMA Impact, Inc,Canadian Medical Association
