Case 38 – update 2 

We have some more results.
Ct scan shows 19cm splenomegally. There is a large lymph node mass in the left iliac fossa measuring 11×12 cm, there is also other widespread large volume abdominal lymphadenopathy. There are a few 1cm groin nodes, no mediastinal lymphodes.
Bone marrow aspirate shows medium sized primitive cells, with basophilic cytoplasm and some vacuolation. There are occasional macrophages seen. Bone marrow shows a dense infiltrate of medium to large mononuclear cells, with a ‘starry sky’ appearance.
Bone marrow immunophenotyping shows a population of cells which are cd45+, cd19+, cd20+, cd22+, fmc7+, cd10+, smig kappa. This population is tdt -, cd5-, cd34-, cd23-.
Cytogenetics have come back and show t(8;14)(q24;q32)
Is this burkitts? What chemotherapy would you give him? Does he need HAART? Any ID doctors who can advise? What do you need to be aware of when starting treatment. What other medications should he be prescribed while on treatment?

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