When the mouth speaks first: oral Burkitt lymphoma unmasks HIV in a young male.

Burkitt lymphoma (BL) is an aggressive B-cell non-Hodgkin lymphoma frequently associated with immunodeficiency states such as HIV infection. This case report describes a 27-year-old male from the Brazilian Amazon who presented with multiple ulcerated gingival swellings, leading to a diagnosis of BL based on histopathological and immunohistochemical findings. The tumor showed a diffuse proliferation of monomorphic medium-sized lymphoid cells with a characteristic starry-sky pattern and immunoreactivity for LCA, CD20, PAX-5, BCL-6, CD10, and MYC, with a Ki-67 index >95 %. Subsequent serological testing revealed a previously undiagnosed HIV infection. Despite prompt initiation of antiretroviral therapy, the patient's condition rapidly deteriorated, resulting in death within two weeks. This case underscores the importance of oral manifestations as early indicators of systemic diseases and highlights the urgent need to improve diagnostic access and healthcare infrastructure in underserved regions.