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Burkitt’s Lymphoma of the Rectosigmoid and Stomach Presenting as Hematochezia

Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Marco Bustamante-Bernal, Juan Galvis, Dubier Matos, Omar Sosa, Saad H. Syed, Osvaldo Padilla, Brian Davis, Marc J. Zuckerman

Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, TX, USA

Am J Case Rep 2016; 17:89-92

DOI: 10.12659/AJCR.896070

Available online:

Published: 2016-02-15

BACKGROUND: Burkitt’s lymphoma (BL) is an uncommon cause of non-Hodgkin lymphoma in adults and accounts for only 0.1–0.5% of all malignant tumors of the colon and rectum. Very few cases of rectosigmoid and stomach BL have been reported in adults.
CASE REPORT: A 51-year-old Hispanic woman presented with a 1-month history of hematochezia, associated with a foreign-body sensation in the rectum and 7 kg weight loss. Initial laboratory workup showed normocytic anemia and positive fecal occult blood. Computed tomography of the abdomen revealed an asymmetric appearance of the stomach and pylorus with nodularity of the mucosa and thickening of the posterior wall, and a 10.8-cm rectal mass. Esophagogastroduodenoscopy and colonoscopy were performed and biopsies of the stomach and rectum were obtained; histopathology demonstrated involvement by Burkitt’s lymphoma in the gastric body nodule and rectal mass. After 4 cycles of chemotherapy, a follow-up abdominal CT demonstrated complete resolution of the mural thickening of the rectum and no intra-abdominal lymphadenopathy.
CONCLUSIONS: Our case illustrates the importance of considering BL in the extensive differential diagnosis of rectal bleeding, change in bowel habits, and other lower and upper GI symptoms, since the rapidly growing nature of this rare malignancy requires a prompt diagnosis and initiation of appropriate therapy.

Keywords: Endoscopy, Digestive System, Burkitt Lymphoma - diagnosis, Female, Gastrointestinal Hemorrhage - etiology, Humans, Middle Aged, Rectal Neoplasms - diagnosis, Stomach Neoplasms - diagnosis