BURKITT'S LYMPHOMA AS A DIFFERENTIAL DIAGNOSIS IN CASES OF ACUTE ABDOMEN: A LITERATURE REVIEW

Abstract

Objective: To conduct a systematic review of Burkitt lymphoma of the gastrointestinal tract, focusing on its clinical presentation in the emergency room and the main differential diagnoses with other causes of acute abdomen, such as appendicitis, intestinal obstruction, and intussusception. Methodology: This is a systematic review focused on understanding the clinical and histopathological aspects that aid in the differential diagnosis of gastrointestinal Burkitt lymphoma. The research was guided by the question: “What are the clinical, radiological, and histopathological characteristics of Burkitt lymphoma of the gastrointestinal tract that can aid in the differential diagnosis with other causes of acute abdomen in patients seen in the emergency room?” Searches were performed in the PubMed/MEDLINE, SciELO, and LILACS databases using the descriptors “Burkitt Lymphoma,” “Digestive System Neoplasms,” “Gastrointestinal Tract,” “Diagnosis, Differential,” and “Lymphoma, Non-Hodgkin,” combined by the Boolean operator “AND.” The search resulted in 234 articles, of which 9 comprised the final sample for the review. Results: Studies have shown that gastrointestinal Burkitt lymphoma, although rare, is a significant cause of acute abdomen, especially in young male patients. The disease presents with nonspecific symptoms such as abdominal pain, nausea, vomiting, and signs of peritoneal irritation, often mistaken for appendicitis or intestinal obstruction. The terminal ileum and ileocecum were the most affected regions, with findings of parietal thickening and intestinal masses associated with mesenteric lymphadenopathy. Computed tomography was essential for the diagnostic suspicion, and confirmation was obtained by biopsy and immunohistochemistry, with expression of CD10, CD20, BCL-6, and c-MYC gene rearrangement. Conclusion: Burkitt lymphoma should be considered in the differential diagnosis of acute abdomen, especially in atypical presentations or those refractory to conventional treatment. Early recognition through imaging tests and histological confirmation is essential to avoid unnecessary surgical interventions and enable the rapid initiation of chemotherapy, improving prognosis. Knowledge of this clinical entity is essential for emergency physicians, surgeons, and clinicians, given its relevance and potential severity.