Asymmetric tonsil hypertrophy may be a sign of Burkitt’s lymphoma

A 4-year-old boy has had cryptic membranous tonsillitis episode 5-6 times since last year and applied to our Ear Nose and Throat (ENT) clinic for the last 3 months of onset of odynophagia. Patient showed asymmetric hypertrophy of the left tonsil (grade 4) and the appearance of ulcerated surface was observed (Figure 1). In computerized tomography; (sections crossing oropharynx levels) it was interpreted as a mass that could be malignant in the soft tissue density of the contour of the left parapharyngeal lesion of approximately 41x31 mm. Tonsillectomy was performed with general anesthesia. Histopathologic and immunohistochemical findings were compatible with Burkitt's lymphoma (BL), CD20 (+) and Ki67 proliferation index were 90% positive (Figure 2). The patient was referred to the oncology clinic for chemotherapy.