Primary Burkitt-like lymphoma of the orbit diagnosed using ultrasound-guided core needle biopsy: A case study

Burkitt-like lymphoma, also known as (B-Cell lymphoma, Unclassifiable) is a rare extra-nodal B-cell lymphoma with features intermediate between Burkitt's lymphoma and diffuse large B-cell lymphoma.A 73-year-old Caucasian female presented to our Emergency Department with orbital pain, deterioration of vision, nausea and vomiting. General examination revealed right orbital proptosis and reduction in visual acuity; and computed tomography confirmed the presence of a right retro-bulbar mass.Tissue samples were obtained using ultrasound-guided core needle biopsy. An experienced head and neck radiologist (SM) undertook the procedure under general anaesthesia, using a lateral orbital approach. The instrument used was the Toshiba Aplio. The procedure was without complication. Results from histopathological, immunohistochemical and genetic analyses confirmed the diagnosis of stage IV orbital Burkitt-like lymphoma with atypical features.Despite the ambiguity of immunohistochemistry and cytogenetic results, the patient was treated for Burkitt's lymphoma. The treatment had to be re-adjusted after two rounds of chemotherapy as the patient developed chemotherapy-induced encephalopathy. The patient remained symptom-free for 8 months. This case demonstrates the application of ultrasound-guided core needle biopsy for rapid and accurate lymphoma diagnosis and sub-classification.