1
|
Akbar M, Clasen-Linde E, Specht L. Extranodal NK/T-cell lymphoma, nasal type, with extranasal presentation - a case report and a review of the literature. Acta Oncol 2020; 59:1480-1487. [PMID: 32689856 DOI: 10.1080/0284186x.2020.1795250] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Extranodal NK/T-cell lymphoma (ENKTCL), nasal type is a very rare and aggressive non-Hodgkin lymphoma. Most commonly it occurs in the upper aerodigestive tract. But, it can also manifest at locations such as the skin, soft tissue, gastrointestinal tract (GI), lungs, testis, etc. These locations are designated as extranasal ENKTCL. The patients with the latter have often more adverse clinical features and poorer survival rate compared with nasal sites. We present a case of an 83-year-old patient with a primary ENKTCL, nasal type, with extranasal presentation in the right upper eyelid. MATERIAL AND METHODS Materials for the literature review was obtained by a comprehensive search on PubMed, which yielded 82 eligible cases with extranasal ENKTCL. RESULTS Sixty-eight cases (83 %) were localized as primary ENKTCL in the lungs (17), central nervous system (CNS) (14), testis (11), GI-tract (7), skin (6), orbit and intraocular tissue (4), pancreas (2), adrenal gland (2), breast (1), etc. 14 cases (17 %) presented as extended or disseminated diseases involving exclusively organs outside the upper aerodigestive tract. There was no systematic pattern of organ involvement in the extended/disseminated ENKTCL. 63 % of the patient with localized extranasal ENKTCL and about 50% of patients with extended/disseminated disease were reported to have died of the disease. Treatment strategies varied with no preferred option. Among the used treatment options were chemotherapy, radiotherapy, surgery, stem cell transplantation alone or in different combinations. CONCLUSION ENKTCL is a highly aggressive disease which may present in extranasal areas. Although the tumors respond to both chemotherapy and radiotherapy, durable complete remissions are very rare.
Collapse
Affiliation(s)
- Momena Akbar
- Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark
| | - Erik Clasen-Linde
- Department of Pathology, Rigshospitalet, University of Copenhagen, Denmark
| | - Lena Specht
- Department of Oncology, Rigshospitalet, University of Copenhagen, Denmark
| |
Collapse
|
2
|
Hu Q, Xu L, Zhang X, Wang J, Zhou Z. Primary pulmonary extranodal natural killer/T-cell lymphoma (ENKTL), nasal type: Two case reports and literature review. Medicine (Baltimore) 2020; 99:e20822. [PMID: 32590768 PMCID: PMC7328944 DOI: 10.1097/md.0000000000020822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Extranodal natural killer/T-cell lymphoma (ENKTL) - nasal type is an aggressive form of malignant non-Hodgkin lymphoma with a very poor prognosis. Especially primary pulmonary ENKTL is a relatively rare form of non-Hodgkin lymphoma. Until now, the prevalence of primary pulmonary ENKTL is unknown. Since 2001, only 18 cases of primary pulmonary ENKTL have been published, in addition to the 2 cases reported here. PATIENT CONCERNS We describe 2 cases of primary pulmonary ENKTL. Both patients were male non-smokers, aged 61 and 49 years. Their main clinical symptoms included cold-like symptoms and intermittent fever (39.3°C and 38.8°C) for some days (40 days and 3 weeks). Both patients had no relevant personal or family medical history. DIAGNOSIS The patients were initially misdiagnosed with community-acquired pneumonia. Primary pulmonary ENKTL was confirmed by immunohistochemical staining of computed tomography-guided transthoracic needle biopsy specimens. Both cases were positive for CD56, CD3, and in situ hybridization for Epstein-Barr virus-encoded small RNA, but negative for CD20. INTERVENTIONS Initially, both patients were treated inadequately with intravenous moxifloxacin administration (unknown dosage and 400 mg q.d) in their local hospitals. Once diagnosed with primary pulmonary ENKTL in our hospital, they received 3 cycles of chemotherapy with combined regimens of dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide (SMILE), and in the second patient, bone marrow transplantation was performed following the third chemotherapy cycle. OUTCOMES Clinical follow-up after the chemotherapy showed that the condition of the first patient progressively deteriorated. He died 2 months following the initial diagnosis. However, the presence of the hemophagocytic lymphohistocytosis gradually improved in the second patient during chemotherapy. Ultimately, the second patient died of acute transplant rejection 6 months after the initial diagnosis. CONCLUSION The diagnosis of ENKTL should be considered when patients present with fever and expansile consolidation of the lung not responding to antibiotics. The diagnosis depends on histopathology and immunophenotyping. Percutaneous transthoracic needle biopsy is a safe and effective biopsy method. Chemotherapy may improve the prognosis, but this should be confirmed by prospective multicenter studies.
Collapse
Affiliation(s)
- Qun Hu
- Department of Respiratory, Critical Care and Sleep Medicine, Xiang’an Hospital, Xiamen University, Xiamen
| | - Liyu Xu
- Department of Pulmonary and Critical Care Medicine, Fuzhou First Hospital, Fujian Medical University, Fuzhou
| | - Xiaoming Zhang
- Department of Cardio-Thoracic Surgery, Shenzhen University General Hospital
| | - Jie Wang
- College of Pharmacy, Shenzhen University, Shenzhen, China
| | - Zizi Zhou
- Department of Cardio-Thoracic Surgery, Shenzhen University General Hospital
- Department of Plastic and Reconstructive Surgery, BG Unfallklinik Ludwigshafen, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
3
|
Qiu YJ, Zhang MZ. [Clinical analyses of 24 patients with primary pulmonary NK/T-cell lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2020; 41:40-46. [PMID: 32023753 PMCID: PMC7357901 DOI: 10.3760/cma.j.issn.0253-2727.2020.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the clinical characteristics, the best treatment and prognostic factors of primary pulmonary NK/T-cell lymphoma. Methods: A total of 24 cases with primary pulmonary NK/T-cell lymphoma from April 2011 to May 2019 were analyzed retrospectively. Survival analysis was performed using the Kaplan-Meier method and groups were compared using the log-rank test. Multivariate analysis using Cox proportional hazard regression model was conducted to confirm independent prognostic factors for overall survival (OS) and progression-free survival (PFS) . Results: ①The cohort of 24 patients included 16 male and 8 female with a median age of 49 years (range, 4-76 years) old. ②Most patients initially presented with a fever (66.7%) , cough and dyspnea. Chest imaging manifestations were primarily unilateral (45.8%) or bilateral (54.2%) pulmonary consolidation, nodules or mass. ③20 patients received chemotherapy, radiotherapy or hematopoietic stem cell transplantation, the rest 4 cases palliative treatment. Median OS was 9.5 months (range, 0.1-26.0 months) . The estimated 1-year OS rate was 45.8%. Overall response rate of patients treated with asparaginase-based regimen was 88.2%. ④In univariate survival analysis, age≤60 was prognostic for longer OS and PFS, compared with age>60 (P=0.002 and 0.004, respectively) ; ECOG≤2 was prognostic for longer OS and PFS, compared with ECOG>2 (P=0.042 and 0.004, respectively) . In multivariate survival analysis, age>60 and ECOG>2 were significantly correlated with inferior OS and PFS (OS: P=0.024 and 0.024, respectively; PFS: P=0.035 and 0.024, respectively) . Conclusions: Primary pulmonary NK/T-cell lymphoma was a rare disease with poor prognosis. Asparaginase-based regimens appeared to be effective. Age and ECOG served as independent prognostic factors for primary pulmonary NK/T-cell lymphoma patients.
Collapse
Affiliation(s)
- Y J Qiu
- Department of Respiratory, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - M Z Zhang
- Department of Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| |
Collapse
|
4
|
Primary pulmonary extranodal NK/T cell lymphoma of an elderly adult: a case report and literature review. J Hematop 2019. [DOI: 10.1007/s12308-019-00380-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
5
|
Yabushita T, Yoshioka S, Furumiya T, Nakamura M, Yamashita D, Imai Y, Ishikawa T. The impact of early diagnosis on the prognosis of extranodal NK/T-cell lymphoma with massive lung involvement: a case report. BMC Pulm Med 2019; 19:48. [PMID: 30791900 PMCID: PMC6385406 DOI: 10.1186/s12890-019-0815-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/14/2019] [Indexed: 12/12/2022] Open
Abstract
Background Pulmonary non-Hodgkin lymphoma (NHL) is rare. The most frequent subtype of pulmonary NHL is low-grade B-cell lymphoma, such as lymphoma of mucosa-associated lymphoma tissue. Extranodal natural killer cell/T-cell lymphoma, nasal type (ENKL) is characterized by predominant extranodal involvement and association with Epstein-Barr virus (EBV). ENKL with massive lung involvement has been infrequently reported, and its prognosis is extremely poor. Case presentation A 20-year-old Japanese man presented with intermittent fever lasting for 2 months. Radiological imaging demonstrated multiple nodules of uneven shape and size in both lungs. Video-assisted thoracic surgical lung biopsy showed abnormal lymphocyte infiltration, which was positive for CD3, CD56, and perforin. In situ hybridization for EBV-encoded RNA was positive. From these findings, he was diagnosed with ENKL with lung involvement. The patient was successfully treated with intensive combinational chemotherapy followed by allogeneic cord blood transplantation. He has been alive with continuous complete remission for 1 year after diagnosis. Conclusions Although ENKL involving the lung has been reported to have dismal outcomes, our patient showed long-term survival after intensive chemotherapy and up-front allogeneic hematopoietic transplantation. The present case highlights the importance of early diagnosis as well as allogeneic transplantation.
Collapse
Affiliation(s)
- Tomohiro Yabushita
- Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Satoshi Yoshioka
- Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan.
| | - Takeru Furumiya
- Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Momoko Nakamura
- Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Daisuke Yamashita
- Department of Pathology, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Yukihiro Imai
- Department of Pathology, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| |
Collapse
|
6
|
Qiu Y, Hou J, Hao D, Zhang D. Primary pulmonary NK/T-cell lymphoma: A case report and literature review. Mol Clin Oncol 2018; 8:753-756. [PMID: 29844905 DOI: 10.3892/mco.2018.1613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 04/18/2018] [Indexed: 11/05/2022] Open
Abstract
Extranodal natural killer (NK)/T-cell lymphoma (ENKTL) is an aggressive disease with poor prognosis. The lung is a relatively rare site of involvement. The current study presents a case of primary pulmonary ENKTL with fever and dyspnea, mimicking pneumonia and initially treated with empirical antibiotics. The patient demonstrated rapid deterioration and died shortly following diagnosis. To the best of our knowledge, large-scale investigations referring to primary pulmonary ENKTL are not available. As a result, the exact incidence and clinical features of primary pulmonary ENKTL are unknown. In the current report, a literature review is presented to discuss the clinical characteristics, diagnosis, treatment, and prognosis factors of this malignant disease.
Collapse
Affiliation(s)
- Yajuan Qiu
- Department of Respiration, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Junna Hou
- Department of Respiration, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Dexun Hao
- Department of Respiration, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Dandan Zhang
- Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| |
Collapse
|
7
|
Mori H, Ebisawa K, Nishimura M, Kanazawa K. Late diagnosis: a case of rapidly progressive extranodal NK/T cell lymphoma, nasal type. BMJ Case Rep 2018; 2018:bcr-2017-221019. [PMID: 29455176 PMCID: PMC5836627 DOI: 10.1136/bcr-2017-221019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Extranodal natural killer (NK)/T cell lymphoma, nasal type is a condition that has poor prognosis. Accurate diagnosis of lymphoma is made by pathological findings. We report a case of extranodal NK/T cell lymphoma, nasal type affecting the lung and liver and which was difficult to diagnose because of negative biopsy results from multiple sites. A 39-year-old man who had dry cough and fever for 1 month was referred to our hospital. He had pancytopenia and elevated serum levels of lactate dehydrogenase and soluble interleukin-2 receptor. Hepatosplenomegaly and multiple lung nodules were found on imaging study. Specimens of bronchoscopic lung, percutaneous liver, bone marrow and random skin biopsies were all negative. Open lung biopsy was not definitive. Unfortunately, disease progression was rapid and fatal before results of pleural fluid cytology and a second liver biopsy showed extranodal NK/T cell lymphoma, nasal type. This report focused on diagnostic planning for rapidly progressive extranodal NK/T-cell lymphoma, nasal type.
Collapse
Affiliation(s)
- Hiroyuki Mori
- Department of General Internal Medicine, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Kei Ebisawa
- Department of General Internal Medicine, Kobe University Hospital, Kobe, Hyogo, Japan
| | | | - Kenji Kanazawa
- General Internal Medicine, Kakogawa Chuo Shimin Hospital, Kakogawa, Hyogo, Japan
| |
Collapse
|
8
|
Song M, Kim JY, Choi JS, Yoon B, Kim M, Kim SJ, Kim SY. Primary Pulmonary Extranodal Natural Killer/T-cell Lymphoma, Nasal Type Presenting as Diffuse Ground Glass Opacities: a Case Report. J Korean Med Sci 2017; 32:1727-1730. [PMID: 28875622 PMCID: PMC5592192 DOI: 10.3346/jkms.2017.32.10.1727] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/13/2016] [Indexed: 11/20/2022] Open
Abstract
Extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKTCL) is a rare type of lymphoma that accounts for only 5%-18% of all cases of non-Hodgkin lymphoma (NHL). In published series, 60%-90% of NK/T-cell lymphomas are localized to the nasal and upper airway. We describe a 55-year man who presented with cough, sputum, dyspnea on exertion, and a chest computed tomography scan shows diffuse ground glass opacities (GGOs), suggestive of an interstitial lung disease. He was treated with a corticosteroid and his symptoms improved. However, when the corticosteroid was tapered, his symptoms recurred. The patient underwent a surgical lung biopsy and ENKTCL was diagnosed. We present this case because ENKTCL involving only the lung is very rare but very informative. To our knowledge, our patient is the first case that primary pulmonary ENKTCL is presented with GGOs.
Collapse
Affiliation(s)
- MyungJin Song
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Ye Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Soo Choi
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Bora Yoon
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - MooHyun Kim
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Jeong Kim
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Song Yee Kim
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
9
|
A case of primary pulmonary NK/T cell lymphoma presenting as pneumonia. Respir Med Case Rep 2015; 17:1-4. [PMID: 27141431 PMCID: PMC4821249 DOI: 10.1016/j.rmcr.2015.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 11/14/2015] [Accepted: 11/17/2015] [Indexed: 02/06/2023] Open
Abstract
Primary pulmonary lymphoma, particularly non-B cell lymphomas involving lung parenchyma, is very rare. A 46-year-old male was admitted to the hospital with fever and cough. Chest X-ray showed left lower lobe consolidation, which was considered pneumonia. However, because the patient showed no response to empirical antibiotic therapy, bronchoscopic biopsy was performed for proper diagnosis. The biopsied specimen showed infiltrated atypical lymphocytes with angiocentric appearance. On immunohistochemical staining, these atypical cells were positive for CD3, CD30, CD56, MUM-1, and granzyme B, and labeled for Epstein–Barr virus encoded RNA in situ hybridization. These findings were consistent with NK/T cell lymphoma. We report on a case of primary pulmonary NK/T cell lymphoma presenting as pneumonic symptoms and review the literature on the subject.
Collapse
|
10
|
Fei W, Xiaohong W, Hong Z, Bei H. Pulmonary Extranodal Natural Killer/T-Cell Lymphoma (Nasal Type): A Case Report and Radiological Image Review. Medicine (Baltimore) 2015; 94:e1527. [PMID: 26402808 PMCID: PMC4635748 DOI: 10.1097/md.0000000000001527] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
An 83-year-old woman presented with intermittent fever for 2 weeks. Chest radiography and computed tomography images showed multiple nodules and masses scattered in both lung fields. Tissue samples obtained by computed tomography-guided needle biopsy revealed extranodal natural killer/T-cell lymphoma (ENKL). The lung is the major site of involvement and the skin may be the primary site. The radiological imaging of this case is different from the cases reported before. Besides, we reviewed the medical records of our hospital and searched the Pubmed database and found 12 cases altogether (include the case presented), which were diagnosed with pulmonary ENKL, and the features of chest images were studied. To our knowledge, this is the first time that the chest imaging features of pulmonary ENKL were reviewed. We conclude that if the radiographic manifestations are multiple patchy consolidations or multiple nodules and masses in both lungs with or without bilateral pleural effusions, the diagnostic considerations should include ENKL.
Collapse
Affiliation(s)
- Wang Fei
- From the Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Haidian district, Beijing, China
| | | | | | | |
Collapse
|
11
|
Chien CC, Lee HS, Lin MH, Hsieh PP. Primary extranodal natural killer/T-cell lymphoma of bronchus and lung: A case report and review of literature. Thorac Cancer 2015; 7:140-4. [PMID: 26816549 PMCID: PMC4718123 DOI: 10.1111/1759-7714.12254] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 02/16/2015] [Indexed: 11/27/2022] Open
Abstract
Primary pulmonary non‐Hodgkin's lymphoma (NHL) is very rare. It represents less than 1% of all NHL, and 0.5–1% of all primary pulmonary malignancies. Almost all cases of primary pulmonary NHL originate from B‐cell lineage. We present a case of a 53‐year‐old man with primary extranodal NK/T‐cell lymphoma of the bronchus and lung, presented progressive dyspnea caused by right lower lung consolidation, and pleural effusion. Initial chest computed tomography suggested advanced lung cancer. Bronchofiberscopy showed a polypoid tumor on which a biopsy was performed. Histologically, the diffusely infiltrative atypical cells were positive for cytoplasmic CD3, CD56, granzyme B, and negative for cytokeratin, CD20 immunostains, suggesting NK/T cell lineages. In situ hybridization for Epstein‐Barr virus encoded ribonucleic acid (EBER) was positive. Herein, we discuss the clinicopathological features of this case and review the literature on primary extranodal NK/T‐cell lymphoma of the lung. Compared with other patients, who died after the first cycle of chemotherapy and/or within three months, our patient had longer survival under aggressive chemotherapy and auto‐peripheral blood stem cell transplantation.
Collapse
Affiliation(s)
- Chu-Chun Chien
- Department of Pathology and Laboratory Medicine Veterans General Hospital- Kaohsiung Kaohsiung Taiwan
| | - Herng-Sheng Lee
- Department of Pathology and Laboratory Medicine Veterans General Hospital- Kaohsiung Kaohsiung Taiwan
| | - Min-Hsi Lin
- Department of Internal Medicine, Chest Division Veterans General Hospital- Kaohsiung Kaohsiung Taiwan
| | - Pin-Pen Hsieh
- Department of Pathology and Laboratory Medicine Veterans General Hospital- Kaohsiung Kaohsiung Taiwan
| |
Collapse
|
12
|
Gui W, Yang B, Shen Q, Bai M, Wang J, Guan T, Zhao J, Wang J, Su L. Successful treatment with L-asparaginase-based regimen for primary pulmonary NK/T cell lymphoma: a case report and review of the literature. CLINICAL RESPIRATORY JOURNAL 2014; 9:493-6. [PMID: 24761980 DOI: 10.1111/crj.12156] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 02/26/2014] [Accepted: 04/21/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Wei Gui
- Department of Hematology; Shanxi Tumor Hospital; Shanxi China
| | - Bin Yang
- Department of Hematology; Shanxi Tumor Hospital; Shanxi China
| | - Quanliang Shen
- Department of Foreign Language; Shanxi Medical University; Shanxi China
| | - Min Bai
- Department of Hematology; Shanxi Tumor Hospital; Shanxi China
| | - Jun Wang
- Department of Hematology; Shanxi Tumor Hospital; Shanxi China
| | - Tao Guan
- Department of Hematology; Shanxi Tumor Hospital; Shanxi China
| | - Jin Zhao
- Department of Hematology; Shanxi Tumor Hospital; Shanxi China
| | - Jingrong Wang
- Department of Hematology; Shanxi Tumor Hospital; Shanxi China
| | - Liping Su
- Department of Hematology; Shanxi Tumor Hospital; Shanxi China
| |
Collapse
|
13
|
Gong L, Wei LX, Huang GS, Zhang WD, Wang L, Zhu SJ, Han XJ, Yao L, Lan M, Li YH, Zhang W. Identification of genuine primary pulmonary NK cell lymphoma via clinicopathologic observation and clonality assay. Diagn Pathol 2013; 8:140. [PMID: 23958352 PMCID: PMC3846405 DOI: 10.1186/1746-1596-8-140] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 08/05/2013] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED Extranodal natural killer (NK)/T-cell lymphoma, nasal type, is an uncommon lymphoma associated with the Epstein-Barr virus (EBV). It most commonly involves the nasal cavity and upper respiratory tract. Primary pulmonary NK/T cell lymphoma is extremely rare. If a patient with a NK or T-cell tumor has an unusual reaction to treatment or an unusual prognosis, it is wise to differentiate NK from T-cell tumors. The clinicopathologic characteristics, immunophenotype, EBV in situ hybridization, and T cell receptor (TCR) gene rearrangement of primary pulmonary NK cell lymphoma from a 73-year-old Chinese woman were investigated and the clonal status was determined using female X-chromosomal inactivation mosaicism and polymorphisms at the phosphoglycerate kinase (PGK) gene. The lesion showed the typical histopathologic characteristics and immunohistochemical features of NK/T cell lymphoma. However, the sample was negative for TCR gene rearrangement. A clonality assay demonstrated that the lesion was monoclonal. It is concluded that this is the first recorded case of genuine primary pulmonary NK cell lymphoma. The purpose of the present work is to recommend that pathologists carefully investigate the whole lesion to reduce the likelihood that primary pulmonary NK cell lymphoma will be misdiagnosed as an infectious lesion. In addition, TCR gene rearrangement and clonal analysis, which is based on female X-chromosomal inactivation mosaicism and polymorphisms at PGK and androgen receptor (AR) loci, were found to play important roles in differentiating NK cell lymphoma from T cell lymphoma. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5205300349457729.
Collapse
Affiliation(s)
- Li Gong
- The Helmholtz Sino-German Laboratory for Cancer Research, Department of Pathology, Tangdu Hospital, the Fourth Military Medical University, Shaanxi Xi'an 710038, China.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
William J, Variakojis D, Yeldandi A, Raparia K. Lymphoproliferative neoplasms of the lung: a review. Arch Pathol Lab Med 2013; 137:382-91. [PMID: 23451749 DOI: 10.5858/arpa.2012-0202-ra] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Diagnosis and classification of lymphomas are based on the morphologic, immunologic, and genetic features that the lesional cells share with their normal B and T lymphocyte counterparts. Primary pulmonary lymphomas account for 0.3% of primary lung neoplasms and less than 0.5% of all lymphomas. OBJECTIVE To describe and summarize the clinical and histopathologic features of the primary pulmonary lymphoma and secondary involvement of the lung by lymphoma. DATA SOURCES Peer-reviewed published literature and personal experience. CONCLUSIONS Diagnosis of clonal lymphoid proliferations in the lung has evolved owing to the greater utility of molecular and flow cytometric analysis of tissue. Further studies are needed to best define the clinical and prognostic features, as well as search for targeted therapy for these patients with rare neoplasms.
Collapse
Affiliation(s)
- Josette William
- Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA
| | | | | | | |
Collapse
|
15
|
Morovic A, Aurer I, Dotlic S, Weisenburger DD, Nola M. NK cell lymphoma, nasal type, with massive lung involvement: a case report. J Hematop 2010; 3:19-22. [PMID: 21436870 DOI: 10.1007/s12308-009-0050-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Accepted: 11/17/2009] [Indexed: 11/26/2022] Open
Abstract
Extranodal NK/T cell lymphoma, nasal type, is an Epstein-Barr virus-associated lymphoma that most commonly involves the nasal cavity and upper respiratory tract. Lung involvement by NK/T cell lymphoma is rare and seldom reported in the literature. We describe the unusual case of a 41-year-old male with NK cell lymphoma, nasal type, who presented with massive secondary lung involvement 2.5 years after the detection of a retroperitoneal mass. The diagnosis was made by open lung biopsy. Despite aggressive treatment, the patient died shortly after the initiation of therapy. Lung involvement by NK/T cell lymphoma occurs most commonly as part of widely disseminated disease and carries a poor prognosis for the patient. Novel agents and innovative therapies need to be developed for this aggressive lymphoma.
Collapse
|
16
|
Tai CF, Chang LY, Lin DT, Lin KH, Jou ST, Yang YL. A case of natural killer cell lymphoma presenting with bilateral pleural effusions and hemophagocytic lymphohistocytosis. Pediatr Blood Cancer 2009; 52:666-9. [PMID: 19156850 DOI: 10.1002/pbc.21943] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Natural killer (NK) cell lymphoma of lung is very rare. We report a case of NK cell lymphoma presented in a 17-year-old male with bilateral pleural effusions and hemophagocytic lymphohistocytosis. Morphologic and immunohistochemical tests revealed an association of NK cell lymphoma with Epstein-Barr virus. A literature review helped identify other cases of patients with NK cell lymphoma, their treatment and outcomes.
Collapse
Affiliation(s)
- Chun-Fu Tai
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|