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Joseph Junewick, MD FACR
over 7 years ago
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CNS Burkitts Lymphoma

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 4 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

Teenager with seizure.


Case Images


Diagnosis

CNS Burkitts Lymphoma

Findings

MR – Axial T1, T2 and post-gadolinium T1 images of the brain show multifocal enhancing lesions with marked mass effect and edema.

Discussion

Burkitt’s lymphoma is a malignant non-Hodgkin’s lymphoma consisting of undifferentiated, B-cells. Three types are described: an endemic form typically found in Africa that typically affects the facial bones; a sporadic form that typically affects the abdominal viscera; and a HIV-associated form. Ebstein-Barr virus has a high association with this disease. Translocation at the c-MYC gene at chromosome 8q24 to the heavy chain on 14q32, or, less commonly, to the light chain at 2q11 is the underlying genetic defect. Primary central nervous system Burkitt’s lymphoma is extremely rare, being described by a few cases reports in the literature. The typical MRI appearance of CNS lymphoma is a poorly defined mass which is isointense on T1WI, hyperintense on T2WI, and diffusely enhancing (ring-enhancement is rare). On spectrospcopy, CNS lymphoma has very high lipid and choline peaks relative to creatinine ratios compared to astrocytomas.

Reference

Takasu M, Takeshita S, Tanitame N, et al. Primary hypothalamic third ventriclular Burkitt’s lymphoma: a
case report with emphasis on differential diagnosis. Br J Radiol (2010); 83:e43–e47.

Sun J, Chen G, Ho C, et al. Primary Burkitt lymphoma of the CNS in an immunocompetent elderly woman. J Med Sci 2008;28(3):141-146.

Contributor

Tod Mattis, MD



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