Primary Burkitt's lymphoma of the postnasal space

Introduction

We present the first reported case of a primary Burkitt's lymphoma of the postnasal space occurring in an adult Caucasian male.

Case report

The patient presented with a 6-week history of a productive cough and a painless left sided cervical swelling.

Examination of the neck revealed a 5 × 5 cm hard mass in the left anterior triangle by the angle of the mandible with no other palpable masses. Fibre-optic nasendoscopy revealed a 3 × 3 cm mass extending from his left Eustachian cushion towards the midline.

A CT scan of the head and neck showed a soft tissue swelling in the post nasal space, with extensive lymphadenopathy along the carotid sheath and deep to the sternomastoid, with the lowest enlarged lymph node being at the level of the hyoid bone.

Immunohistochemical staining and in-situ hybridisation for Epstein-Barr Virus (EBV) revealed the tumour to be EBV RNA negative suggesting this was a rare sporadic form of the tumour. The case further serves to illustrate the diversity of histological subtypes of malignancies that may develop at this concealed site.

Conclusion

Review of the literature suggests nasopharyngeal Burkitt's lymphoma occurs only in childhood. To our knowledge, this is this is the first reported case in the world literature of primary nasopharyngeal Burkitt's lymphoma presenting in an adult Caucasian male.