A rare cause of gallbladder perforation: Burkitt's lymphoma

Although the perforation of gallbladder rarely occurs, it is a high-risk and life-threatening condition. High rates of mortality and morbidity are associated with late diagnosis. Burkitt’s lymphoma is a disease, which starts in B-cells and develops with leukemia and extranodal involvement. Involvement of gallbladder wall is a very rare location of extranodal lymphomas. In this case, a 68-year-old woman with severe pain in the left arm referred to our outpatients’ clinic where anti-HCV (+), leukocytosis, elevated sedimentation rate, and thrombocytopenia were found in her initial tests. On the basis of these findings, further tests were performed and she was diagnosed with Burkitt’s lymphoma. She had acute abdomen and  gallbladder perforation was detected by radiologic study. Urgent laparotomy was performed and she subsequently underwent cholecystectomy and drain insertion. Postoperative septic shock developed and she died due to multiple organ dysfunction syndrome. The determined diagnosis was described as gallbladder wall perforation associated with Burkitt’s lymphoma infiltration in the pathology report. It is very important for the clinicians to take into the consideration that a rare cause of gallbladder perforation is Burkitt’s lymphoma and it has an aggressive postoperative clinical course.