Sinonasal Burkitt’s CD20 Negative Lymphoma : A Case Report

Abstract

Burkitt's lymphoma is a B Cells non-lymphoma Hodgkin's that is aggressive, has a high degree of gradation, and is made up of diffuse, non-cleaved, undifferentiated, tiny cells that usually expresses CD20 positive . A very uncommon kind of juvenile cancer is Burkitt lymphoma (LB). 1, 2 100 new cases are recorded annually in the United States, compared to a frequency of 100 cases per million children in Africa. We report this case because of the rarity of Burkitt’s CD20 negative lymphoma. A 9-year-old girl who has a main complaint of eye swollen for almost two months. A bump with redness, swelling, and discomfort in the left eye that radiates to the head occurs after two weeks of before entering the hospital. Another complaint made by the patient was a big, pus-oozing lump in the left cheek and nose. On MSCT Scan examination, a solid mass was found in the left maxillary sinus, left ethmoid sinus, right left frontal sinus, left sphenoid sinus, left nasal cavity, and entered the extra orbital and left intraconal cavities, which forced the bulbus oculi to anterosuperior and caused proptosis bulbi. The mass also extended to the left parasella and caused destruction of the medial, anterior, and lateral walls of the left maxillary sinus. the patient will be treated with chemotherapy with the CHOP regimen with a dose of Cyclophosphamide 600 mg/m2 per body surface area (LPT), Doxorubicin 50 mg/m2 per LPT, Oncovin/Vincristine 1.4 mg/m2 per LPT, and Prednisone 50 mg. So the patient received Cyclophophamide 468 mg, Doxorubicin 40 mg, and Oncovin/Vincristine 1 mg. Then the patient was admitted to undergo the first chemotherapy. In this case it was suffered by a 9 year old girl and the symptoms of a lump in the eye and left cheek were getting bigger and bigger, with histopathological results obtained cells with "Starrys Sky" pattern, which supports the diagnosis of Burkitt's Lymphoma so that the patient receives chemotherapy treatment. The result of immunohistochemical staining for CD20 was negative.The chemotherapy regimen consist of cychlosfamide, doxorubicin, oncovin and prednisone. Patient was diagnosed with stage II E Burkitt lymphoma, ECOG I, ccomplete respons.