Primary intestinal Burkitt's lymphoma in a Syrian child with a challenging initial presentation: A case report and literature review.

Introduction: Burkitt's lymphoma is an aggressive type of non-Hodgkin lymphoma that represents approximately 30% of pediatric lymphomas and less than 5% of all pediatric malignancies. Although the involvement of the gastrointestinal tract is a common finding in sporadic Burkitt's lymphoma, primary intestinal lymphomas still represent a rare entity. Case presentation: We are reporting the case of an 11-year-old Syrian male who presented to our hospital with complaints of abdominal pain, distention, and tenderness. Clinical and radiologic examinations demonstrated moderate ascites with an abdominal mass. Interestingly, the cytological study of the ascites revealed the diagnosis of Burkitt's lymphoma which was later confirmed by histopathological and immunohistochemical examinations. Discussion: Pleural effusions are a common finding in extranodal lymphomas, whereas ascites is considered a rare initial presentation constituting less than 2% of lymphoma cases. Conclusion: We aimed to present an extremely rare case of a primary intestinal Burkitt's lymphoma initially presenting with ascites, highlighting the major role of the cytological study of ascites in the primary diagnosis, and the essential role of histological and immunohistochemical examinations in confirming the diagnosis in challenging cases.