Approximately 75% to 80% of American patients with Burkitt's lymphoma have abdominal tumor when seen initially, which in three quarters of the patients is localized to the gastrointestinal (GI) tract.1 The small intestine is most commonly involved, giving rise to abdominal pain, malaise, fatigue, anemia, and diarrhea. Intussusception is common, bleeding from the bowel is a frequent accompaniment, and perforation may rarely occur.
To our knowledge, only one patient, a 38-year-old man, has been described in the literature as having dysphagia as the first complaint in Burkitt's lymphoma.2 We report herein a second case in a male adolescent and review some of the differential diagnoses.
Report of a Case.—A 16-year-old boy was referred to the National Institutes of Health (NIH) with a diagnosis of lymphoma. Three months earlier he had begun to experience fatigue and loss of weight that was attributed by his physician to a viral