SECONDARY INVOLVEMENT OF THE ADRENAL, PANCREAS AND THYROID IN AN ADOLESCENT WITH DISSEMINATED BURKITT LYMPHOMA

Abstract

Introduction: Lymphomas are cancers that arise from the white blood cells and have been traditionally divided into two large subtypes: Hodgkin and non-Hodgkin lymphoma. B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma; almost 75% of patients with lymphoma have this variant. Lymphomas can potentially arise from any lymphoid tissue located in the body; however, secondary involvement in the adrenal, pancreas and thyroid is very uncommon. We report the history, examination findings, staging images results of a 17 -year-old adolescent man diagnosed with a Burkitt lymphoma. Case report: Adolescent, male, 17 years old, with the appearance of a subclavicular nodule on the right since November 2023, extending to the axillary region; without presenting fever, weight loss, night sweats, abdominal pain. Admitted to the service in June 2024 with a previous lymph node biopsy result with a reactional appearance. Evolving from April 2024 with a significant increase in the mass, associated with paresthesia of the hand and pain when moving the right upper limb. Chest tomography showed a solid mass in the right axillary region (16.4 × 12.7 × 15.5 cm); with involvement of the axillary and subclavian vessels on the right, maintaining contact with the right lateral and anterior chest wall up to the skin; nodular lesions in the bilateral thyroid parenchyma; lesions compatible with lymphoproliferative disease. Abdominal tomography showed a solid mass in the body of the pancreas (5.8 × 5.2 cm), a solid mass in the topography of the left adrenal gland (10.4 × 6.2 cm), solid nodular lesions in the cortex of the bilateral kidneys (up to 3.2cm on the left); all lesions compatible with metastases. Performed on the lymph node conglomerate that diagnosed Burkitt's lymphoma, the patient concluded the stage without bone marrow involvement but with involvement in the cerebrospinal fluid, defining it as stage IV. Chemotherapy treatment was started with good clinical response and images. Conclusion: Based on this case and a review of the literature, secondary involvement of the adrenal, pancreas and thyroid does not affect the patient's prognosis like involvement of the cerebrospinal fluid or bone marrow. However, this case characterizes an unusual presentation of Burkitt's lymphoma with involvement of three endocrinological organs simultaneously.