INCREASINGLY COMMON PRESENTATION OF EXTRANODAL BURKITTS LYMPHOMA WITH SURPRISINGLY RAISED PLEURAL/ASCITIC FLUID ADENOSINE DEAMINASE LEVELS

Abstract

Acute onset polyserositis as a presentation of Non Hodgkins lymphoma(NHL) occurs in 20% of individuals.(1-4) Etiology being a jumble between an Extranodal Burkitt lymphoma(ENBL),a pyothorax associated lymphoma and a primary effusion lymphoma as a cause of such effusions.(5) We report a case series of 5 such patients of NHL,four of which received chemotherapy with standard CHOP regimen.However,all patients succumbed.The common ndings of strikingly raised uid adenosine deaminase(ADA) levels in all of these effusions establishes a possible etiopathological link(ENBL).(6) An immunocompetent status renders primary effusion lymphoma unlikely which also has high uid ADA levels.This case series proposes a rational approach towards such cases of suspected ENBL presenting with acute onset lymphocytic polyserositis and a negative HIV antibody status with enormously raised uid ADA levels thereby permitting timely institution of chemotherapy for a better patient prognosis.