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Case Study
- Diagnostic challenge in Burkitt lymphoma of the mandible initially misdiagnosed as osteomyelitis: a case report
- Jiwon Do, Jin-Young Choi
- J Pathol Transl Med. 2025;59(6):460-466. Published online November 14, 2025
- DOI: https://doi.org/10.4132/jptm.2025.09.18
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Abstract
PDF - Burkitt lymphoma (BL) is a highly aggressive B-cell neoplasm that rarely involves the mandible in elderly without apparent immunodeficiency. We report a case of a 72-year-old male who presented with persistent mandibular pain following extraction of tooth #46. Initial imaging findings were consistent with incipient osteomyelitis, and the patient was treated with antibiotics. Despite treatment, pain persisted, and follow-up imaging revealed swelling and diffusion restriction in the lateral pterygoid muscle without evidence of a distinct mass. Biopsy revealed BL confirmed by immunohistochemistry: CD10+, BCL6+, c-MYC+, Ki-67 >95%, and negative for BCL2, MUM-1, and Epstein-Barr virus. Although c-MYC immunopositivity was demonstrated, fluorescence in situ hybridization for MYC rearrangement could not be performed due to limited tissue, representing a diagnostic limitation. Notably, the patient had no trismus despite deep muscle involvement, but complained of facial paresthesia and showed remote swelling in the scapular area during hospitalization. Systemic staging with imaging, cerebrospinal fluid cytology, and imaging revealed disseminated nodal and extranodal involvement including the central nervous system, corresponding to stage IV disease by Lugano classification. This case highlights the diagnostic challenge of distinguishing lymphoma from osteomyelitis and underscores the importance of considering malignancy in cases of refractory mandibular inflammation with atypical features.
Original Article
- Application of Epstein-Barr Virus Cell Lines (CCL85 EB-3) in Performing the EBER mRNA In Situ Hybridization as a Positive Control.
- Sung Sook Kim, Woon Sup Han, Joo Young Suh, Joo Ryung Huh
- J Pathol Transl Med. 1996;7(1):38-43.
- 2,116 View
- 20 Download
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Abstract
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- Epstein-Barr virus(EBV) is associated with a wide spectrum of benign and malignant disorders including leukoplakia, Hodgkin's lymphoma, central nervous system lymphoma, peripheral T cell lymphoma and nasopharyngeal undifferentiated carcinoma. There are several distinctive aspects of biology of the virus that are important in investigation of virus in clinical specimens. The abundant expression of the EBER mRNA transcripts makes possible the sensitive detection of latent expression in EBV-associated tumors. Although there has been a dramatic increased interest in the direct characterization of EBV in clinical specimens, there have been few studies about the effective and reliable positive controls in performing in situ hybridization technique for EBV, especially on paraffin-embedded tissue. We applied Burkitts lymphoma cell line as positive control in EBV in hydridization using Oncor Kit. The cell block of Burkitt lymphoma cell line(CCL85 EB-3) showed strong and specific positivity for EBER in situ in nuclei of EBV infected cells.
Case Report
- Fine Needle Aspiration Cytological Findings of Burkitt lymphoma: A Brief Case Report.
- Hyang Jeong Jo, Jung Taek Oh, Gang Deuk Kim, Hun Soo Kim
- J Pathol Transl Med. 2007;18(2):175-177.
- 2,885 View
- 82 Download
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Abstract
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- A case of Burkitt lymphoma diagnosed through fine needle aspiration cytology is described. A 66-year-old man presented with lymphadenopathy on the right cervical neck and axillary area. An ultrasonogram and CT scan for the cervical neck showed a multiple variable sized lymphadenopathy with pericapsular invasion and necrotic foci. Fine needle aspiration cytology (FNAC) of the cervical lymph nodes revealed very cellular and necrotic smears consisting of diffusely scattered intermediate monotonous round cells, tingible body macrophages and many mitotic figures. Histological features of the excised lymph nodes showed the classic morphological features of Burkitt lymphoma. Recognition of the characteristic cytological features can suggest the possibility of Burkitt lymphoma.
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