Hosoda K, Shimizu A, Kubota K, Notake T, Hayashi H, Yasukawa K, Umemura K, Kamachi A, Goto T, Tomida H, Yamazaki S, Narusawa Y, Asano N, Uehara T, Soejima Y. Gallbladder Burkitt’s lymphoma mimicking gallbladder cancer: A case report. World J Gastroenterol 2022; 28(6): 675-682 [PMID: 35317428 DOI: 10.3748/wjg.v28.i6.675]
Corresponding Author of This Article
Akira Shimizu, MD, PhD, Associate Professor, Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan. ashimizu@shinshu-u.ac.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Kiyotaka Hosoda, Akira Shimizu, Koji Kubota, Tsuyoshi Notake, Hikaru Hayashi, Koya Yasukawa, Kentaro Umemura, Atsushi Kamachi, Takamune Goto, Hidenori Tomida, Shiori Yamazaki, Yuji Soejima, Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto 390-8621, Japan
Yuri Narusawa, Naoko Asano, Takeshi Uehara, Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto 390-8621, Japan
Author contributions: Hosoda K, Kubota K, Notake T, Hayashi H, Umemura K, Kamachi A, Goto T, Tomida H, and Yamazaki S were the patient’s hepato-biliary-pancreatic surgeons, they reviewed the literature and contributed to manuscript drafting; Narusawa Y, Asano N, and Uehara T were involved in pathology evaluation; Shimizu A and Soejima Y were responsible for revising the manuscript for important intellectual content; all the authors provided final approval for the version of the manuscript to be submitted.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Akira Shimizu, MD, PhD, Associate Professor, Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan. ashimizu@shinshu-u.ac.jp
Received: October 1, 2021 Peer-review started: October 1, 2021 First decision: November 7, 2021 Revised: November 23, 2021 Accepted: January 19, 2022 Article in press: January 19, 2022 Published online: February 14, 2022 Processing time: 131 Days and 5.1 Hours
Abstract
BACKGROUND
Malignant lymphoma is a rare form of gallbladder malignancy. Most of these malignancies are diffuse large B-cell lymphomas or mucosa-associated lymphoid tissue-type lymphomas; however, Burkitt’s lymphoma of the gallbladder is extremely rare, and only two previous reports are available in the literature. Herein, we report a rare case of Burkitt’s lymphoma of the gallbladder mimicking gallbladder adenocarcinoma.
CASE SUMMARY
An 83-year-old man with no abdominal complaints was found to have a gallbladder tumor and periportal lymph node enlargement on computed tomography (CT) performed for hypertension screening. His laboratory data revealed slightly elevated serum levels of carcinoembryonic antigen and soluble interleukin 2 receptor. Imaging examinations revealed two irregular and contrast-enhanced masses extending into the gallbladder lumen, but these did not infiltrate the serosa. Moreover, a periportal lymph node had enlarged to 30 mm. Based on these findings, we diagnosed the patient as having gallbladder adenocarcinoma with lymph node metastasis, which was treated using bile duct resection with gallbladder bed resection and periportal lymph node dissection. However, the patient was finally diagnosed as having Burkitt’s lymphoma. Although the surgical margin was pathologically negative, recurrence was noted at the hepatic radical margin and superior pancreaticoduodenal lymph nodes on positron emission tomography/CT soon after discharge. Thus, he was referred to a hematologist and started receiving treatment with reduced-dose cyclophosphamide, doxorubicin, vincristine, and prednisone.
CONCLUSION
Burkitt’s lymphoma can occur in the gallbladder. Biopsy can be useful in cases with findings suggestive of gallbladder malignant lymphoma.
Core Tip: Malignant lymphoma is a rare form of gallbladder malignancy, and Burkitt’s lymphoma of the gallbladder is especially rare, with only two previous reports available in the literature. We report a case of gallbladder Burkitt’s lymphoma that was preoperatively indistinguishable from gallbladder carcinoma. Unfortunately, the patient had lymphoma recurrence immediately after the surgery because of delayed chemotherapy initiation owing to postoperative complications due to an extended surgery. Although accurate preoperative diagnosis of gallbladder malignant lymphoma is quite difficult, some findings are suggestive of gallbladder malignant lymphoma, and hence, biopsy is recommended in these cases.
