Adult Burkitt's lymphoma: Two patients with an unusual clinical picture

Traditionally, Burkitt's lymphoma has been considered as a childhood disease. This aggressive neoplasm tends to present as an extranodal lymphoma and often involves the alimentary tract. Thus, diagnosis may be difficult and explorative laparatomy may be required. The disease is rare among adults, and the prognosis, especially in adults, is poor, although early and appropriate management may achieve encouraging results. Two HIV negative adult patients with Burkitt's lymphoma with an unusual clinical picture are reported. The first patient presented with septicaemia and bacterial peritonitis, followed by acute abdomen. Surgery established the diagnosis of Burkitt's lymphoma. The second patient was admitted for evaluation and treatment of deep vein thrombosis. Workup revealed pelvic mass, the removal of which led to the diagnosis. Aggressive chemotherapy achieved complete remission. The literature regarding Burkitt's lymphoma is reviewed, emphasizing that early diagnosis, debulking surgery, metabolic stabilization, aggressive combination chemotherapy and prevention of potentially fatal tumour lysis syndrome are mandatory steps to improve the prognosis of these patients.