Burkitt Lymphoma Presenting as Acute Abdomen: Beyond Infection and Diverticulitis

Burkitt lymphoma (BL) is a highly aggressive mature B-cell non-Hodgkin lymphoma and a clinically important entity in pediatric oncology. In the sporadic form, abdominal involvement is frequent and may present with nonspecific gastrointestinal symptoms that can mimic common infectious or surgical conditions. However, presentations mimicking other acute surgical conditions, including Meckel-related complications with secondary peritonitis, are exceedingly rare and described almost exclusively in isolated case reports. We report the case of a previously healthy adolescent who presented with acute abdominal pain initially suggestive of a benign or infectious etiology, which subsequently evolved to a clinical picture compatible with Meckel's diverticulitis and peritonitis. Progressive clinical deterioration prompted extended imaging and surgical exploration, which ultimately led to the diagnosis of sporadic Burkitt lymphoma and the prompt initiation of chemotherapy, with rapid clinical improvement. This case illustrates the diagnostic challenges posed by atypical abdominal presentations of Burkitt lymphoma in older children and underscores the importance of including lymphoproliferative disease in the differential diagnosis of adolescents with persistent or unexplained abdominal symptoms in order to facilitate earlier recognition and optimize outcomes.