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Pathology Forum
February 2000

Quiz Case 2

Arch Otolaryngol Head Neck Surg. 2000;126(2):239-240. doi:

Waldeyer ring lymphomas constitute 5% to 10% of all malignant lymphomas and 60% to 70% of all extranodal head and neck lymphomas.1 Malignant neoplasms of the nasopharynx account for 1% of all malignancies in childhood.2 Lymphoma is the most common malignancy of the nasopharynx in children.3 Primary nasopharyngeal BL usually involves male adolescents; it is extremely rare in adults.4 Burkitt lymphoma was described in 1958 as a sarcoma involving the jaws of African children.5 It was not recognized as a lymphoma until 1963.6 It is endemic in equatorial Africa and sporadic throughout the rest of the world. In 1965, O'Conor et al7 described a childhood lymphoma in the United States that was histologically identical to African BL. From that point on, BL was subclassified into endemic (African) and nonendemic (American) forms. African BL and American BL are histologically identical, but they affect different age groups and anatomical locations. African BL usually affects children in the first decade of life, whereas American BL affects adolescents and young adults in the second decade of life. African BL preferentially affects the jaw. In contrast, American BL shows an equal predilection for the jaw and nasopharynx (6.6% and 5%, respectively).8 Moreover, primary cervical lymph node involvement is more common in American BL than in African BL.4

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