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Irritable Bowel Syndrome: Like Symptoms in a Patient With Burkitt Lymphoma of the Ileum


Alkully, Turki MD1; Darr, Umar MD1; Hammad, Tariq MD1; Khalil, Basmah MD2; Nawras, Ali MD, FACG1

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American Journal of Gastroenterology: October 2015 - Volume 110 - Issue - p S459
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Introduction: Burrkitt lymphoma is a highly aggressive type of B- cell lymphoma. It is generally divided to 3 types: Endemic (Africa), Sporadic (non-endemic), and immunodeficiency. The sporadic class is the most common type of Burkitt lymphoma in US. Here we present a unique case of a 71- year- of gentleman who presented with irritable bowel syndrome - like symptoms whom was later diagnosed with Burkitt lymphoma.

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Case report: 71-year-old Caucasian male presented to the gastroenterology clinic with chronic abdominal pain that has been worsening over the last 3 months. The pain was described as intermittent and postprandial. The patient had a computed tomography scan of the abdomen and pelvis with contrast which revealed thickening and enhancement of the terminal ileum as well as mesenteric lymphadenopathy. The patient underwent a colonoscopy with intubation of the terminal ileum which showed a infiltrative terminal ileal mass measuring 10cm in length within terminal ileaum. Multiple biopsies were obtained. Pathology revealed immunohistochemistry stains as negative for chromogranin, synaptophysin and pancytokeratin, CD3, CD5 and cyclin D1. The lymphoid cells were clearly positive for CD20, CD10, BCL6 and MUM1. Ki-67 showed almost 100% proliferative index. Results were negative for Immunoglobulin heavy chain gene arrangement, supporting the diagnosis of Burkitt lymphoma.

Conclusion: Irritable bowel syndrome like symptoms can be manifestations of many underlying medical conditions. Burkitt lymphoma could be one of these underlying conditions.

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