Abdominal Burkitt Lymphoma in Children: CT Finding

ABSTRACT

PURPOSE: To evaluate the CT findings of Burkitt's lymphoma involving the abdomen in children. MATERIALS AND METHODS: We retrospectively analyzed the abdominal CT of ten children who presented with abdominal symptom. Theywere confirmed by operation in two cases and by fine needle aspiration biopsy in eight to be suffering from Burkitt's lymphoma. We also abdominal ultrasonography(USG) (n=10) and carried out small bowel follow-through examination(SBS) (n=5). Analyses focused on features of the abdominal mass bowel wall thickening, ascites, lymphadenopathy, and the involvement of intra-abdominal solid organ. RESULTS: Abdominal CT at the time ofpresentation showed a huge conglomerated mass encasing segments of small bowel and also peripherally displacingbowel loops (n=9), bowel wall thickening (n=10), and ascites (n=10). In three of these cases, we were able to see tumor necrosis and cavity formation. Extensive infiltration into mesenteric fat and obliteration of tissue planemade it impossible to identify on CT the margin of the tumor and the presence of mesenteric lymphadenopathy. Infour patients, sonography showed enlarged mesenteric lymph nodes(15-20mm), and in three, retroperitoneal lymphnodes(5mm, 10mm, 12mm in long dimension) were detected on CT and USG. CONCLUSION: Abdominal CT can reveal the characteristic imaging features of Burkitt's lymphoma in children. These are a huge conglomerate mass with or without cavity formation, that encases the small bowel and infiltrates the mesentery, ascites, and the relatively spared retroperitoneal lymph nodes.