Tubo-Ovarian Presentation of Burkitt’s Lymphoma: Case Report

Abstract

Burkitt’s lymphoma rarely presents as a primary of the ovary. High index of suspicion is required to avoid delay of definitive management. There are a few case reports presented on ovarian Burkitt’s lymphoma. We present a case of a 23 year old, para 1+1 HIV negative patient who presented to the Kenyatta National Hospital with a one month history of progressive abdominal swelling, fatigue, lower limb swelling, nausea and vomiting. Abdominal examination, revealed bilateral adnexal masses confirmed by ultrasonography. She underwent emergency laparotomy following a diagnosis of bilateral ovarian masses with torsion. Surgical specimen  showed tubo-ovarian tissue with sheets of lymphoid cells of small to intermediate size, with numerous tangible body macrophages depicting a starry sky appearance. Immunohistochemistry demonstrated a strongly positive CD20, a positive CD 10, a 90-95% positive Ki67, a positive Bcl6 and a negative pan-CK. A definitive diagnosis of tubo-ovarian Burkitt’s was made. The patient unfortunately succumbed before commencement of chemotherapy. Autopsy, concluded the cause of death to be widely disseminated Burkitt’s lymphoma, with a most likely tubo-ovarian primary and intestinal obstruction. Burkitt’s lymphoma should be considered as a differential diagnosis in ovarian masses for timely diagnosis and management.