以口腔颌面部病变为首发症状的儿童伯基特淋巴瘤1例报告及文献综述

doi:10.7518/hxkq.2024.2023432

华西口腔医学杂志 ›› 2024, Vol. 42 ›› Issue (5): 675-682.doi: 10.7518/hxkq.2024.2023432

以口腔颌面部病变为首发症状的儿童伯基特淋巴瘤1例报告及文献综述

武宏¹^,²(), 赵文慧¹(), 杨小倩¹, 李秀丽³, 张衍蓉⁴, 宋爱梅¹()

^1.山东大学齐鲁医学院口腔医学院·口腔医院牙周病科山东省口腔组织再生重点实验室口腔生物材料与组织再生山东省工程研究中心山东省口腔疾病临床医学研究中心，济南 250012
^2.日照市人民医院口腔科，日照 276800
^3.山东省立医院小儿血液科，济南 250021
^4.济宁市兖州区口腔医院正畸科，济宁 272100

收稿日期:2023-12-09 修回日期:2024-07-05 出版日期:2024-10-01 发布日期:2024-09-21
通讯作者: 宋爱梅 E-mail:wh880902@163.com;973688451@qq.com;sam1972@sdu.edu.cn
作者简介:武宏，主治医师，硕士，E-mail：wh880902@163.com|赵文慧，主治医师，学士，E-mail：973688451@qq.com
基金资助:
山东省自然科学基金(ZR2020MH184)

Burkitt lymphoma manifested by initial oral and maxillofacial lesions: a case report in a child patient and review of related articles

Wu Hong¹^,²(), Zhao Wenhui¹(), Yang Xiaoqian¹, Li Xiuli³, Zhang Yanrong⁴, Song Aimei¹()

^1.Dept. of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan 250012, China
^2.Dept. of Stomatology, People’s Hospital of Rizhao, Rizhao 276800, China
^3.Dept. of Hematology, Shandong Provincial Hospital, Jinan 250021, China
^4.Dept. of Orthodontics, Hospital of Stomatology of Yanzhou District of Jining, Jining 272100, China

Received:2023-12-09 Revised:2024-07-05 Online:2024-10-01 Published:2024-09-21
Contact: Song Aimei E-mail:wh880902@163.com;973688451@qq.com;sam1972@sdu.edu.cn
Supported by:
Natural Science Foundation of Shandong Province(ZR2020MH184)

摘要/Abstract

摘要：

伯基特（Burkitt）淋巴瘤是一种具有高度侵袭性的B细胞淋巴瘤，是增殖最快的人类恶性肿瘤，早期发现具有较高的治疗成功率，晚期则预后较差。本病可发生于儿童和成人，包括地方型（非洲Burkitt淋巴瘤）、散发型和免疫缺陷相关型。散发型Burkitt淋巴瘤最常见的首发部位是腹部器官及淋巴结，以口腔颌面部为首发症状的Burkitt淋巴瘤少见。本文报道1例以面部膨隆、牙痛、牙齿松动等口腔颌面部病变为首发症状的儿童散发型Burkitt淋巴瘤患者，同时对以口腔颌面部病变为首发症状的Burkitt淋巴瘤的发病情况进行文献综述，以期为广大口腔临床医师提供参考，从而对以口腔疾病为表现的Burkitt淋巴瘤患者做到早诊断、早治疗，提高治疗成功率。

关键词: Burkitt淋巴瘤, 面部膨隆, 牙齿松动

Abstract:

Burkitt lymphoma is a highly aggressive B-cell lymphoma and the fastest proliferating human malignant tumor. If the disease is found in the early stage, the patient could have a high possibility to be cured successfully, whereas the prognosis is poor in the late stage. Burkitt lymphoma can occur in children and adults, and it is categorized as local (Africa), sporadic, and immunodeficiency associated type. Sporadic Burkitt lymphoma mainly affects children and adolescents, and the most common initial sites are abdominal organs and lymph nodes. Sporadic Burkitt lymphoma manifested by initial oral and maxillofacial lesions is relatively rare. Here, a case of pediatric sporadic Burkitt lymphoma, with oral and maxillofacial lesions as the first symptoms, was reported. The patient was treated in the Department of Periodontology, Shandong University School and Hospital of Stomatology. After timely checkup was provided, the patient was transferred to another hospital and had good results. In this article, an incidence of Burkitt lymphoma, with oral and maxillofacial lesions as the first symptom, was reviewed to provide reference for oral clinicians to achieve early diagnosis and treatment of patients with Burkitt lymphoma with oral diseases and improve the success rate of treatment.

Key words: Burkitt lymphoma, facial distention, loose teeth

中图分类号:

R739.8

武宏, 赵文慧, 杨小倩, 李秀丽, 张衍蓉, 宋爱梅. 以口腔颌面部病变为首发症状的儿童伯基特淋巴瘤1例报告及文献综述[J]. 华西口腔医学杂志, 2024, 42(5): 675-682.

Wu Hong, Zhao Wenhui, Yang Xiaoqian, Li Xiuli, Zhang Yanrong, Song Aimei. Burkitt lymphoma manifested by initial oral and maxillofacial lesions: a case report in a child patient and review of related articles[J]. West China Journal of Stomatology, 2024, 42(5): 675-682.

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疾病	病理表现
弥漫性大B细胞淋巴瘤	较多的核分裂像和凋亡小体^[13]
急性淋巴母细胞白血病/淋巴瘤	细胞小，胞浆少，核染色质细腻，不见核仁或核仁不清楚^[13]
小淋巴细胞性淋巴瘤	小淋巴细胞弥漫性增生浸润，“假滤泡”形成^[13]
髓性白血病	肿瘤细胞表达髓细胞标志物髓过氧化物酶、溶菌酶等，胞质中常可见嗜酸性颗粒^[14]
粒细胞肉瘤	瘤细胞胞质一般较丰富，嗜酸性，免疫组织化学髓过氧化物酶阳性，CD15阳性^[15]
非淋巴造血系统小细胞恶性肿瘤（Ewing/ PNET、神经母细胞肿瘤、小细胞未分化癌等）	Ewing/PNET及神经母细胞肿瘤中可见菊形团结构，两者神经均表达内分泌标志物CgA和Syn，Ewing/PNET同时强表达CD99，小细胞未分化癌低分子量角蛋白阳性^[14]

首发症状	是否误诊	误诊诊断	首发至确诊时间	预后	参考文献
上颌骨牙槽突区域或下颌骨肿瘤	/	/	/	死亡	[3]
右鼻脓涕带血、面部肿胀	是	鼻炎、鼻窦炎	5个月	死亡	[16]
右唇颊沟肿块	是	面部粉瘤	20个月	好转	[23]
右颌下包块	是	炎症疾病	1年	良好	[28]
左眼睑肿块	/	/	1月余	死亡	[21]
左眶下肿块、眼球突出、上颌骨膨大	是	骨髓炎	/	死亡	[21]
右耳前包块	是	淋巴结炎	1年余	死亡	[21]
颏部肿块	/	/	1月余	死亡	[20]
左下颌前庭肿胀	是	急性牙槽脓肿	2周余	/	[8]
右颈部肿物	/	/	1年	/	[19]
颌面部肿瘤	是	颌面间隙感染并颌下淋巴结炎	/	死亡	[19]
左颌下肿块	是	淋巴结炎	/	/	[29]
右颈部包块	/	/	1个月	良好	[18]
下唇麻木	是	炎症疾病	1个月	好转	[25]
左颌下肿块	是	淋巴结炎	9 d	死亡	[30]
右颌面部膨隆	是	左侧黏膜囊肿	/	死亡	[27]
左下唇麻木伴左下颌疼痛	是	颌骨及牙龈肿物/面部粉瘤	1个月	/	[13]
左下牙龈肿痛伴面部麻木	是	炎症疾病	2月余	良好	[22]
右侧后牙区肿胀伴牙松动	是	右下颌骨囊肿	1个月	/	[26]
右下面部肿胀	否	/	20 d	死亡	[7]
口齿不清、咽部肿物、面神经麻痹	否	/	10 d	好转	[24]

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以口腔颌面部病变为首发症状的儿童伯基特淋巴瘤1例报告及文献综述

Burkitt lymphoma manifested by initial oral and maxillofacial lesions: a case report in a child patient and review of related articles

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