RESUMEN
BACKGROUND: Burkitt lymphoma is a high-grade B cell lymphoma which accounts for less than 1% of all adult cases of non-Hodgkin lymphoma. Rare instances of Burkitt lymphoma developing secondary to prior irradiation have been described in the literature. CASE PRESENTATION: We report a case of a 90-year-old white woman with a recent history of irradiation for Hodgkin lymphoma, who presented with primary Burkitt lymphoma of the supraglottic larynx. She underwent emergency awake tracheostomy with biopsy. A histopathological examination confirmed non-Hodgkin, B cell lymphoma of Burkitt type. Given her age and poor functional status, she underwent treatment with palliative radiotherapy. CONCLUSIONS: A literature review was performed to clarify the clinical characteristics of radiation-induced Burkitt lymphoma in the head and neck, as well as its diagnosis and management. The present case represents the second case of radiation-induced Burkitt lymphoma in the head and neck in the reported literature, and the first in the supraglottic larynx. It highlights the need to maintain a broad differential in the assessment of malignancies of the larynx, particularly in patients with a prior history of radiation treatment.
Asunto(s)
Linfoma de Burkitt/patología , Enfermedad de Hodgkin/radioterapia , Neoplasias Laríngeas/patología , Laringe/patología , Neoplasias Inducidas por Radiación/patología , Anciano de 80 o más Años , Linfoma de Burkitt/terapia , Resultado Fatal , Femenino , Humanos , Neoplasias Laríngeas/diagnóstico por imagen , Neoplasias Inducidas por Radiación/terapia , Tomografía Computarizada por Rayos XAsunto(s)
Neoplasias del Sistema Nervioso Central/diagnóstico , Infecciones por Virus de Epstein-Barr/diagnóstico , Células Asesinas Naturales/patología , Leucemia Prolinfocítica de Células T/diagnóstico , Antineoplásicos/uso terapéutico , Neoplasias del Sistema Nervioso Central/líquido cefalorraquídeo , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/patología , Infecciones por Virus de Epstein-Barr/líquido cefalorraquídeo , Infecciones por Virus de Epstein-Barr/tratamiento farmacológico , Infecciones por Virus de Epstein-Barr/patología , Resultado Fatal , Herpesvirus Humano 4/patogenicidad , Herpesvirus Humano 4/fisiología , Humanos , Células Asesinas Naturales/efectos de los fármacos , Células Asesinas Naturales/metabolismo , Leucemia Prolinfocítica de Células T/líquido cefalorraquídeo , Leucemia Prolinfocítica de Células T/tratamiento farmacológico , Leucemia Prolinfocítica de Células T/patología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Recurrencia , Columna Vertebral/efectos de los fármacos , Columna Vertebral/inervación , Columna Vertebral/patología , Linfocitos T/efectos de los fármacos , Linfocitos T/metabolismo , Linfocitos T/patologíaAsunto(s)
Anemia Refractaria con Exceso de Blastos/tratamiento farmacológico , Antimetabolitos Antineoplásicos/efectos adversos , Azacitidina/efectos adversos , Mastocitosis Sistémica/inducido químicamente , Anciano , Anemia Refractaria con Exceso de Blastos/patología , Antimetabolitos Antineoplásicos/uso terapéutico , Azacitidina/uso terapéutico , Resultado Fatal , Humanos , Masculino , Mastocitosis Sistémica/patologíaAsunto(s)
Médula Ósea/patología , Leucemia de Mastocitos/diagnóstico , Leucemia Mieloide/diagnóstico , Mastocitos/patología , Mastocitosis Sistémica/diagnóstico , Adulto , Células Clonales/patología , Diagnóstico Diferencial , Errores Diagnósticos , Progresión de la Enfermedad , Resultado Fatal , Femenino , Humanos , Infecciones/etiología , Cariotipificación , Leucemia de Mastocitos/sangre , Leucemia de Mastocitos/genética , Leucemia de Mastocitos/patología , Leucemia Mieloide/sangre , Leucemia Mieloide/complicaciones , Leucemia Mieloide/genética , Leucemia Mieloide/patología , Masculino , Mastocitosis Sistémica/sangre , Mastocitosis Sistémica/complicaciones , Mastocitosis Sistémica/genética , Mastocitosis Sistémica/patología , Persona de Mediana Edad , Síndromes Mielodisplásicos/diagnóstico , Mielopoyesis , Células Madre Neoplásicas/patología , Coloración y Etiquetado , Urticaria/etiologíaRESUMEN
A recent phase III trial comparing granulocyte colony-stimulating factor (G-CSF)-stimulated bone marrow (G-BM) and G-CSF-mobilized peripheral blood (G-PB) in matched sibling allograft recipients showed that G-BM produced a similar hematologic recovery but a reduced incidence of extensive chronic graft-versus-host disease, indicating differences in the cell populations infused. As a first step toward identifying these differences, we treated a group of healthy adult humans with 4 daily doses of G-CSF 10 microg/kg and monitored the effects on various hematopoietic and immune cell types in the PB and BM over 12 days. G-CSF treatment caused rapid and large but transient increases in the number of circulating CD34+ cells, colony-forming cells, and long-term culture-initiating cells and in the short-term repopulating activity detectable in nonobese diabetic/severe combined immunodeficiency/beta2-microglobulin-null mice. Similar but generally less marked changes occurred in the same cell populations in the BM. G-CSF also caused transient perturbations in some immune cell types in both PB and BM: these included a greater increase in the frequency of naive B cells and CD123+ dendritic cells in the BM. The rapidity of the effects of G-CSF on the early progenitor activity of the BM provides a rationale for the apparent equivalence in rates of hematologic recovery obtained with G-BM and G-PB allotransplants. Accompanying effects on immune cell populations are consistent with a greater ability of G-BM to promote tolerance in allogeneic recipients, and this could contribute to a lower rate of chronic graft-versus-host disease.