青少年单侧扁桃体增大诊断伯基特淋巴瘤1例并文献复习

Burkitt lymphoma presenting as unilateral tonsil enlargement in an adolescent:a case report and literature review

伯基特淋巴瘤属于高侵袭性B细胞非霍奇金淋巴瘤,特点是快速生长,原发于扁桃体的伯基特淋巴瘤少见。大部分病例早期无明显特异性表现,临床表现多样,儿童患者表现更不典型,易误诊、漏诊。本文报道我院1例单侧扁桃体增大,最终确诊为伯基特淋巴瘤(Burkitt lymphoma,BL)的青少年患者。对于短期内扁桃体增大较快、扁桃体不对称(Brodsky分级,双侧扁桃体大小差异≥2度),临床以局部症状为主,无明显全身症状,颈部多未触及肿大淋巴结,实验室检查无异常者,需及时完善颈部CT或MRI检查,或者进一步完善PET/CT检查,结合其影像学检查结果不能排除可疑恶性肿瘤征象时,尤其是PET/CT检查SUVmax值较高时,应行扁桃体活检。早期发现、早期诊断,有助于改善Burkitt淋巴瘤患者的预后。本例患者诊断及时、准确,手术切除左侧扁桃体缓解了局部症状,术后病理确诊后及时完善化疗,治疗效果良好,目前处于长期跟踪随访。

Burkitt lymphoma is a highly aggressive B-cell non-Hodgkin lymphoma characterized by rapid growth,and Burkitt lymphoma originating in the tonsil is rare.Most of the cases have no obvious specific symptoms in the early stage,and the clinical symptoms are varied.Children's symptoms are more atypical,which are easy to be misdiagnosed and missed.We report a case of adolescent with unilateral tonsil enlargement in our hospital,who was diagnosed with Burkitt lymphoma(BL).For patients with rapid enlargement of the tonsils in a short period,asymmetry of the tonsils(Brodskyscale tonsil size difference≥2 degrees),mainly local symptoms but without obvious systemic symptoms,and rare enlarged lymph nodes in the neck,and no obvious abnormalities in laboratory tests,CT or MRI examination of the neck,or further PET/CT examination should be completed in time.When suspected malignant tumors revealed on imaging,especially high value of SUVmax on PET/CT,tonsil biopsy should be performed.Early detection.Early diagnosis can improve the prognosis of Burkitt lymphoma.In this case,the diagnosis was timely and accurate.Surgical resection of the left tonsil alleviated local symptoms in this cas,and chemotherapy treatment was timely completed after postoperative pathology.Efficacy of surgery combined with chemotherapy is good for the patient and long-term follow-up is available.