ABSTRACT
UNLABELLED: Extranodal lymphomas represent up to 40% of all lymphomas and their prevalence is still increasing. Sporadic BL is rare. It occurs mainly in young men and is associated with viral infection in only about 30% of cases. Most frequently it affects the digestive tract. CASE REPORT: 46-year-old patient was admitted to hospital due to painless tuberous changes of right occipital region and cheek, weakness and non-specific abdominal pain. Clinical examination revealed hepatomegaly. Leucocytosis, raised level of transaminases and LDH were found. Imaging investigations disclosed the enlargement of epigastric lymph nodes and thickening of stomach wall. FNAB of the cheek's tumor allowed to suspect a lymphoma. Biopsy specimens taken from the stomach, cheek and bone marrow confirmed the diagnosis of BL. Microscopic examination revealed cellular infiltration consisting of monomorphic, lymphoid cells with round or oval nuclei containing a few nucleoli with scanty cytoplasm. Mitoses, also atypic, were very numerous. Immunohistochemistry staining was very characteristic for this type of lymphoma: CD20, CD79a, CD10, C-myc, IgM positive, MIB positive in 100% of neoplasmatic cells. There was no evidence of EBV infection. In gastric specimens Helicobacter pylori infection was found. CONCLUSION: Clinical features of sporadic BL are often very non-typical. It is important to diagnose BL in its early stage, because it responds well to treatment and there is a chance of full recovery. Relation between H. pylori infection and BL is probable but demands further investigations.
