Unusual Ampullary Presentation of Pediatric Burkitt Lymphoma: Case Report and Literature Review.
Introduction: Burkitt lymphoma (BL) is a highly aggressive B-cell non-Hodgkin lymphoma that typically presents with abdominal masses; ampullary involvement with obstructive jaundice and gastrointestinal bleeding is exceptionally rare in children. Early biliary decompression can be crucial to permit...
| Published in: | Clinical Medicine Insights: Case Reports Vol. 19; pp. 1 - 13 |
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| Main Authors: | , , , , , , , , , , |
| Format: | case study diagnostic images pictorial tables/charts Journal Article |
| Published: |
Sage Publications Inc.
3/19/2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=192433530&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 192433530 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11795476 B3KM jtl: Clinical Medicine Insights: Case Reports issn: 11795476 maglogo: Y pubinfo: dt: 3/19/2026 vid: 19 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 192433530 192433530 192433530 10.1177/11795476261429279 192433530 ppf: 1 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Unusual Ampullary Presentation of Pediatric Burkitt Lymphoma: Case Report and Literature Review. aug: au: Malik, Khadija Saleem, Muddassir Syed Amjad, Hammad Bin Kamran, Nidal Hussain, Syed Muhammad Faiq Akhtar, Umme Roman Haseeb, Abdul Raza, Ahmed Asad Jawed, Muhammad Areeb Samadi, Abedin Ahmed, Adil affil: Department of Medicine, Civil Hospital Karachi, Pakistan sug: subj: Lymphoma, B-Cell Diagnosis Duodenal Neoplasms Abdominal Pain Etiology Vomiting Etiology Constipation Etiology Jaundice Etiology Melena Etiology Adolescence Male Physical Examination Hepatomegaly Enzymes Blood Laboratory Test Interference Liver Diseases Ultrasonography Tomography, X-Ray Computed Endoscopy, Gastrointestinal Gastrointestinal Hemorrhage Biopsy Immunohistochemistry In Situ Hybridization, Fluorescence Biliary Tract Diseases Surgery Rituximab Cyclophosphamide Vincristine Doxorubicin Methotrexate Ifosfamide Etoposide Cytarabine Adolescent: 13-18 years Male ab: Introduction: Burkitt lymphoma (BL) is a highly aggressive B-cell non-Hodgkin lymphoma that typically presents with abdominal masses; ampullary involvement with obstructive jaundice and gastrointestinal bleeding is exceptionally rare in children. Early biliary decompression can be crucial to permit timely chemotherapy. Case presentation: A 14-year-old boy presented with 1 week of worsening abdominal pain, non-bilious vomiting, constipation, jaundice, and melena. Examination showed pallor, icterus, firm hepatomegaly, and a palpable epigastric mass. Laboratory testing revealed cholestatic liver function abnormalities and elevated pancreatic enzymes. Ultrasound and contrast computed tomography demonstrated a large retroperitoneal mass compressing the biliary tree. Upper gastrointestinal endoscopy identified a friable, ulcerated ampullary mass with active bleeding. Biopsy confirmed BL by morphology (starry-sky) and immunohistochemistry/fluorescence in situ hybridization (CD20+, CD10+, c-MYC+, Ki-67 ~95%). Main diagnosis made was pediatric BL presenting with ampullary involvement causing obstructive jaundice and upper gastrointestinal bleeding. Given persistent cholestasis and bleeding risk, the patient underwent Roux-en-Y choledochojejunostomy for biliary decompression, followed by initiation of rituximab–cyclophosphamide–vincristine–doxorubicin–high-dose methotrexate/rituximab–ifosfamide–etoposide–high-dose cytarabine (R-CODOX-M/R-IVAC) with central nervous system prophylaxis. Post-operative bilirubin improved, and early chemotherapy cycles were tolerated. During the 2-week hospitalization, the patient had symptomatic improvement; however, objective radiologic response could not be documented because care was transferred and post-transfer positron emission tomography–computed tomography was unavailable. Conclusion: Ampullary BL should be considered in pediatric patients with obstructive jaundice and upper gastrointestinal bleeding. Surgical biliary decompression can stabilize cholestasis and facilitate timely multi-agent chemotherapy. pubtype: Academic Journal doctype: case study diagnostic images pictorial tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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