Adult Burkitt's Lymphoma; Rare but Real!

In one of my previous post on Burkitt's lymphoma, I said, this condition is commoner in children.Read about childhood tumour here!
Here is a rare occurrence of Burkitt's lymphoma in an adult, as posted by The Lancet, enjoy;

A 64-year-old male farmer presented to our hospital in April, 2013, with a 3 month history of painless, progressive swelling of his chest wall and lower jaw, and 10 kg unintentional weight loss. On examination he had multiple lumps about 3 × 1·5 cm around the angle of the mandible, and multiple 10 × 8 cm lumps at the mid sternal region and of the left lower anterior chest wall (figure). These lumps were non-tender to palpation, hard, and tethered, with irregular contours, no tempertature changes or overlying skin changes. Blood tests were normal and HIV serology was negative. CT Chest showed a soft tissue mass 8 × 10·6 × 8 cm encasing and eroding the body of sternum with presternal and retrosternal soft tissue components (appendix), and whole-body PET CT fusion showed increased 18F-fluorodeoxyglucose (18F-FDG) uptake (appendix). Histological and immunohistochemical examination of a biopsy specimen from the chest wall swelling showed tightly-packed small round cells with high mitotic activity infiltrating fat and starry sky appearance (figure), positive for CD20, Bcl-2, Mum-1, and Bcl-6, and negative for CD10, CD3, Cyclin-D1, and TdT, with Ki-67 nearly 100%. Conventional cytogenetics showed complex structural and numerical abnormalities including characteristic t (8;14) (appendix). We diagnosed high risk group adult Burkitt lymphoma stage IV, and started treatment with modified Magrath regimen of four alternating cycles of R-CODOX-M and R-IMVAC chemotherapy. The patient achieved complete remission with disappearance of sternal swellings, normal peripheral blood counts, normal bone marrow aspirate, and no evidence of 18FDG uptake on repeat PET scan. He remained in remission at last 3 month follow-up in December, 2013.

Hope he gets well quick!!!