1
|
Sun Y, Liu H, Xie P, Zhu P, Meng X. The CT findings of extranodal natural killer/T-cell lymphoma, nasal type involving the gastrointestinal tract. Eur Radiol 2025:10.1007/s00330-025-11369-8. [PMID: 39878902 DOI: 10.1007/s00330-025-11369-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Revised: 12/16/2024] [Accepted: 12/18/2024] [Indexed: 01/31/2025]
Abstract
OBJECTIVES To analyze the CT imaging features of extranodal natural killer/T (NK/T)-cell lymphoma, nasal type (ENKTCL-NT) involving the gastrointestinal tract (GI), and to compare them with those of Crohn's disease (CD) and diffuse large B-cell lymphoma (DLBCL). MATERIALS AND METHODS Data were retrospectively collected from 17 patients diagnosed with GI ENKTCL-NT, 68 patients with CD, and 47 patients with DLBCL. The CT findings of ENKTCL-NT were analyzed and compared with those of CD and DLBCL. Data were analyzed using SPSS (version 25.0) and MedCalc (version 18.2.1). p < 0.05 was considered statistically significant. RESULTS The 17 patients with ENKTCL-NT included 11 males (64.7%) and 6 females (35.3%) (mean age, 46.41 ± 4.12 years). The CT features of ENKTCL-NT included: circumferential symmetric thickening (100%), moderate thickening (70.6%), skip lesions (52.9%), contiguous lesion (47.1%), mucosal or layered enhancement (70.6%), moderate mural enhancement (64.7%) with non-enhanced regions (47.1%), absence of lymphadenopathy (76.5%), bowel perforation or fistula (17.6%), and peri-enteric blurred fat space (70.6%). The presence of circumferential symmetric thickening, moderate mural enhancement, and non-enhanced regions were more indicative of ENKTCL-NT than CD (17/17 vs. 17/68, 11/17 vs. 22/68, 8/17 vs. 0/68, p < 0.05). The presence of skip lesions, mucosal or layered enhancement, and absence of peri-enteric lymphadenopathy were more indicative of ENKTCL-NT than DLBCL (9/17 vs. 2/47, 12/17 vs. 1/37, 13/17 vs. 19/47, p < 0.05). CONCLUSION CT imaging features can provide useful information for the early diagnosis of ENKTCL-NT and effectively differentiate it from CD and DLBCL. KEY POINTS Question Extranodal natural killer/T-cell lymphoma, nasal type (ENKTCL-NT) involving the gastrointestinal tract (GI) is highly malignant but easily misdiagnosed by clinicians and endoscopic examination. Findings CT could provide useful information in the diagnosis of ENKTCL-NT involving GI and in differentiating it from Crohn's disease and diffuse large B-cell lymphoma. Clinical relevance This study will help improve the ability of radiologists to diagnose ENKTCL-NT involving GI, and a more predictive diagnosis will also alert clinicians to perform multiple deep endoscopic biopsies, which will contribute to the early diagnosis and treatment of ENKTCL-NT.
Collapse
Affiliation(s)
- Yi Sun
- Department of Radiology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hailing Liu
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Pathology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Peiyi Xie
- Department of Radiology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Pan Zhu
- Department of Radiology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaochun Meng
- Department of Radiology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
| |
Collapse
|
2
|
Jiang YY, Chi C, Zeng YP, Jin HZ. Erythematous plaques and nodules with orogenital ulcerations. J Dtsch Dermatol Ges 2019; 17:464-467. [PMID: 30933422 DOI: 10.1111/ddg.13812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yan-Yun Jiang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Cheng Chi
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue-Ping Zeng
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hong-Zhong Jin
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
3
|
Rekha JS, Kar R, Jacob SE, Siddaraju N, Suryanarayana BS, Thabah MM, Naik R, Maroju NK. Extranodal NK/T Cell Lymphoma of the Jejunum Complicated by Hemophagocytic Syndrome: Practical Problems Encountered by a Pathologist. Indian J Hematol Blood Transfus 2014; 30:190-4. [PMID: 25332575 DOI: 10.1007/s12288-013-0324-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 12/24/2013] [Indexed: 11/29/2022] Open
Abstract
Extranodal NK/Tcell lymphomas (ENKTL) are rare, aggressive lymphomas. The most common primary site of involvement is the nasal cavity, nasopharynx and paranasal sinuses. The other sites of primary involvement are skin, gastrointestinal tract and testis. Advanced disease can show lymph node, bone marrow and peripheral blood involvement. We report a case of ENKTL of the jejunum, showing peripheral pancytopenia and haemophagocytosis in the bone marrow. The intestine showed multiple intestinal perforations, with evidence of infiltration by lymphoma with coexistent strongyloides infestation. The patient showed disseminated disease in the form of lymphadenopathy and had a rapidly downhill course and expired on 5th day of admission. We also discuss the problems encountered by the pathologist in diagnosing these uncommon lymphomas.
Collapse
Affiliation(s)
- Jinkala Sree Rekha
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006 India
| | - Rakhee Kar
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006 India
| | - Sajini Elizabeth Jacob
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006 India
| | - Neelaiah Siddaraju
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006 India
| | | | - Molly Mary Thabah
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006 India
| | - Rakesh Naik
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006 India
| | - Nanda Kishore Maroju
- Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006 India
| |
Collapse
|