Infect Chemother.  2018 Mar;50(1):51-54. 10.3947/ic.2018.50.1.51.

A Case of Jejunal Intussusception caused by Burkitt Lymphoma in an Acquired Immunodeficiency Syndrome Patient

• Baek DY
• Heo DH
• Oh SM
• Hwang JH
• Hwang JH
• Park HS
• Lee CS

• KMID: 2407970
• DOI: http://doi.org/10.3947/ic.2018.50.1.51

Abstract

Non-Hodgkin's lymphoma of B-cell type is the second most common neoplasm after Kaposi's sarcoma among patients with human immunodeficiency virus infection. Most non-Hodgkin's lymphoma cases that are associated with acquired immunodeficiency syndrome (AIDS) involve extranodal sites, especially the digestive tract and the central nervous system. We report a case of multiple jejunal intussusception caused by Burkitt lymphoma in a 42-year-old AIDS patient. Upper gastrointestinal endoscopy and surgical biopsy were performed and a complete diagnostic study including histological and immunohistochemical analyses showed Burkitt lymphoma.

Keyword

Burkitt lymphoma; AIDS; Intussusception

MeSH Terms

Acquired Immunodeficiency Syndrome*
Adult
B-Lymphocytes
Biopsy
Burkitt Lymphoma*
Central Nervous System
Endoscopy, Gastrointestinal
Gastrointestinal Tract
HIV
Humans
Intussusception*
Lymphoma, Non-Hodgkin
Sarcoma, Kaposi

Figure

• 

  Figure 1 Abdomen computed tomography scan showed target appearance in the jejunum with severe upstream dilatation of the small bowel (red arrow).

• 

  Figure 2 During operation, the intussusception point looked like a mass. Bowel movement and color were intact. Five intussusception points (black arrow) were found and small bowel segment resection was performed at three sites.

• 

  Figure 3 Low power view revealed a bluish mass involving the intestinal wall (H-E, x40).Scattered benign histiocytes were present in the diffuse tumor cells, giving a “starry sky” pattern (H-E, ☓100). The tumor cells were medium-sized with similar nuclear size to that of histiocytes. The nuclei were round with finely clumped and dispersed chromatin (H-E, ☓400).The tumor cells showed strong expression of CD20 and CD10. In situ hybridization revealed nuclear Epstein-Barr virus-encoded small RNA (EBER). The tumor cells were negative for bcl-2. Because the tumor had an extremely high proliferation fraction, nearly all of the cells were positive for Ki67.

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