1
|
Marques-Piubelli ML, Sales GTM, Clemente LC, Rosa LI, Savioli ML, Alvim RP, Moreira RM, Frassetto FP, do Nascimento ECT, Siqueira SAC. Extranodal NK/T-cell lymphoma, nasal type with extensive cardiopulmonary involvement. Autops Case Rep 2021; 11:e2021246. [PMID: 33968824 PMCID: PMC8087349 DOI: 10.4322/acr.2021.246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Extranodal NK/T-cell lymphoma, nasal type (ENKTL-NT) is a rare type of Non-Hodgkin’s lymphoma, which usually presents with extranodal involvement and affects the nasal/upper aerodigestive tract in the classical presentation. Herein, we report the case of a 31-year-old, previously healthy, male patient diagnosed with ENKTL-NT with the involvement of the lung parenchyma and heart. Unfortunately, due to the rapid disease progression, the diagnosis was performed only at the autopsy. The authors highlight the rare clinical presentation of this type of lymphoma, as well as the challenging anatomopathological diagnosis in necrotic samples.
Collapse
Affiliation(s)
- Mario L Marques-Piubelli
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Patologia. São Paulo, SP, Brasil.,The University of Texas MD Anderson Cancer Center, Department of Translational Molecular Pathology. Houston, Texas, USA
| | | | - Letícia Campos Clemente
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Patologia. São Paulo, SP, Brasil
| | - Lidiane Inês Rosa
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Hematologia e Hemoterapia. São Paulo, SP, Brasil
| | - Mariana Lorenzi Savioli
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Hematologia e Hemoterapia. São Paulo, SP, Brasil
| | - Ricardo Pires Alvim
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia. São Paulo, SP, Brasil
| | - Raquel Megale Moreira
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Nefrologia. São Paulo, SP, Brasil
| | | | | | | |
Collapse
|
2
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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
|
3
|
Xu Y, Wang J, Zhang W, Liu J, Cao X, He A, Chen Y, Gu L, Lei B, Zhang P, Ma X. Extended Course and Increased Dose of Initial Chemotherapy for Extranodal Nasal Type Natural Killer/T (NK/T)-Cell Lymphoma in Patients <60 Years Old: A Single-Center Retrospective Cohort Study. Med Sci Monit 2016; 22:4297-4311. [PMID: 27843135 PMCID: PMC5117239 DOI: 10.12659/msm.897650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Extranodal NK/T-cell lymphoma (ENKTL) of the nasal type is highly invasive and relatively resistant to chemotherapy. This study aimed to assess the efficacy and safety of an extended chemotherapy regimen with increased dose intensity. MATERIAL AND METHODS This was a retrospective cohort study of 69 patients <60 years old with an ECOG score 0-2 treated for ENKTL at the Second Affiliated Hospital of Xi'an Jiaotong University between January 2004 and December 2013. The outcomes were compared between patients who received >8 courses of high-intensity chemotherapy (n=37) vs. 6-8 courses (n=18) and <6 courses (n=14) of conventional chemotherapy. Regimens included improved CHOP, CHOP-E, EPOCH, MAED, MMED, SMILE, and Hyper-CVAD with an increased dose intensity in the >8 courses group. RESULTS The mean follow-up was 52 months (8 to 82 months). Remission rate did not differ significantly when compared among the 3 groups after 3 courses of chemotherapy (83.8%, 77.8%, and 78.6%, respectively, overall P=0.834), but the 5-year overall survival (OS) differed significantly (63.5%, 45.1%, and 22.9%, respectively, overall P=0.030), as did progression-free survival (PFS) (59.1%, 36.0%, and 15.1%, respectively, overall P=0.020), disease-free survival (DFS) (54.1%, 35.5%, and 12.9%, respectively, overall P=0.022), and total relapse rate throughout follow-up (37.04%, 50.0%, and 88.89%, respectively, overall P=0.027). There were no differences in adverse effects among the 3 groups. CONCLUSIONS These results suggest improved OS, PFS, DFS, and relapse rate in young patients with ENKTL receiving >8 courses of high-intensity chemotherapy.
Collapse
Affiliation(s)
- Yan Xu
- Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland)
| | - Jin Wang
- Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland)
| | - Wanggang Zhang
- Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland)
| | - Jie Liu
- Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland)
| | - Xingmei Cao
- Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland)
| | - Aili He
- Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland)
| | - Yinxia Chen
- Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland)
| | - Liufang Gu
- Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland)
| | - Bo Lei
- Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland)
| | - Pengyu Zhang
- Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland)
| | - Xiaorong Ma
- Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi, China (mainland)
| |
Collapse
|
4
|
Kim K, Oh Y, Lim SN, Choi SY, Lee OJ, Choe KH, Lee KM, An JY. Single pleural relapse of a nasal-type extranodal natural killer/t-cell lymphoma: a case report. Tuberc Respir Dis (Seoul) 2014; 76:184-7. [PMID: 24851133 PMCID: PMC4021267 DOI: 10.4046/trd.2014.76.4.184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 09/30/2013] [Accepted: 10/01/2013] [Indexed: 11/30/2022] Open
Abstract
A nasal-type extranodal natural killer/T-cell lymphoma is considered an aggressive form of non-Hodgkin's lymphoma, with approximately half of all patients relapsing during the follow-up period, and most relapses occurring within the first 2 years of remission. Here we report an unusual case of a 42-year-old man who experienced recurrence in single pleura after 8 years of remission.
Collapse
Affiliation(s)
- Keunmo Kim
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Youngmin Oh
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Sung-Nam Lim
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Song-Yi Choi
- Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ok-Jun Lee
- Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Kang-Hyeon Choe
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ki-Man Lee
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jin-Young An
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| |
Collapse
|