Burkitt-like lymphoma with 11q aberration confirmed by needle biopsy of the liver: A case report.

ABSTRACT

BACKGROUND: Burkitt-like lymphoma with 11q aberration (BLL-11q) is a rare provisional lymphoma, and the majority of cases are usually diagnosed by excisional lymph node biopsy. Here we report a case of BLL-11q diagnosed by needle biopsy of the liver in order to improve further understanding of the disease, reduce misdiagnosis, and identify treatment regimens. CASE SUMMARY: The patient was a 67-year-old male. He complained of increased frequency of stools for more than one year, periumbilical pain and discomfort exceeding 3 mo. A computed tomography scan suggested an appendiceal malignant tumor with multiple metastases of the peritoneum, omentum, and liver. Needle biopsy of liver nodules showed that the tumor cells were of median size, the shape was consistent, a small number of tumor cells were large, the "starry sky" pattern was evident, and some tissue cells showed multiple apoptotic debris with coarse particles. Immunohistochemistry was positive for CD20, CD10, BCL6, and MYC. The Ki-67 proliferation index was more than 95%. Molecular biological detection indicated a lack of MYC, BCL2 and BCL6 gene rearrangement with 11q aberration. Therefore, the diagnosis was BLL-11q of the liver. After eight courses of chemotherapy, the abdominal and pelvic peritoneal masses and liver nodules had almost disappeared. The patient recovered well after a follow-up period of more than 13 mo. CONCLUSION: BLL-11q is rare, but patients treated with standard chemotherapy for Burkitt lymphoma can have a good prognosis. Reducing the dose of chemotherapy or developing specific therapies to prevent overtreatment may be considered, but more case studies are needed.