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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.
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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
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Liu S, Zhou X, Song A, Huo Z, Wang Y, Liu Y. Nasal-type extranodal natural killer/T-cell lymphoma presenting with a mass on the buttock: A case report. Medicine (Baltimore) 2019; 98:e18260. [PMID: 31804361 PMCID: PMC6919438 DOI: 10.1097/md.0000000000018260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Nasal-type extranodal natural killer (NK)/T-cell lymphoma is a highly unusual disease with no standard curative managements yet. Our focus is to emphasize a very rare case of nasal-type extranodal NK/T-cell lymphoma with onset of the mass on the buttock successfully operated by combination of surgical excision together with chemotherapy. The management of these unique cases is of great clinical guiding significance. PATIENT CONCERNS A 20-year-old woman presented with a 2-month history of continuous and progressive severe pain on her left buttock. Since December 2017, the patient developed nasal congestion, accompanied with mild pain in the left eye, and new subcutaneous nodules on both cheeks. DIAGNOSIS Postoperative pathology confirmed the diagnosis of extranodal NK/T cell lymphoma. This is an extremely rare presentation of nasal-type NK/T-cell lymphoma. INTERVENTIONS The patient underwent enlarged resection of the tumor on the buttock. After the diagnosis of extranodal NK/T-cell lymphoma was established, the patient received chemotherapy and autologous hematopoietic stem cell transplantation. OUTCOMES The patient's symptoms improved significantly after the surgery, and the postoperative period was uneventful at the 1-year follow-up visit. There were no complications associated with the operation and adjuvant therapies during the follow-up period. LESSONS Taken together, the lesion's clinical features, imaging results, and pathological characteristics are unique. Extranodal NK/T-cell lymphoma, although rare, should be part of the differential diagnosis when the patient presents with the mass on the buttock. We recommend enlarged excision of the extranodal lymphoma. Combined of surgical excision of the extranodal lymphoma, chemotherapy and autologous hematopoietic stem cell transplantation are good choice for proper treatment.
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Affiliation(s)
- Shuzhong Liu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences
| | - Xi Zhou
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences
| | - An Song
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission
| | - Zhen Huo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Yipeng Wang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences
| | - Yong Liu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences
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Wu CC, Takahashi E, Asano N, Miyata-Takata T, Takata K, Furukawa K, Elsayed AA, Hu LM, Satou A, Kohno K, Kosugi H, Ohashi K, Kinoshita T, Nakamura S, Kato S. Primary cutaneous NK/T-cell lymphoma of nasal type: an age-related lymphoproliferative disease? Hum Pathol 2017; 68:61-68. [PMID: 28873353 DOI: 10.1016/j.humpath.2017.08.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 08/10/2017] [Accepted: 08/23/2017] [Indexed: 11/29/2022]
Abstract
Among extranodal NK/T-cell lymphoma of nasal type (NKTL), the extranasal variant (ENKTL) is known to have a worse prognosis with advanced clinical stage than the nasal variant of NKTL. However, detailed clinicopathological features of the localized extranasal disease have not been well documented in English literature. Here, we described the clinicopathological profiles of 14 patients with stage I ENKTL, including 7 in the skin, 5 in the gastrointestinal tract, and 2 in the central nervous system, highlighting the distinctiveness of the first. The 7 primary cutaneous (PCNKTL) cases were characterized by an older onset age (median, 76 versus 53 years, P=.012) and a more favorable clinical course (P=.041) compared with 17 patients with stages II-IV ENKTL that showed cutaneous involvement. The skin lesions in the PCNKTL group were distributed in the face or neck (n=4) and limbs (n=3) but not the trunk, which was most frequently affected (60%, P=.017) in the latter group. Furthermore, the stage I cutaneous disease showed a female predominance (male-female, 2:5 versus 7:0; P=.021) and a significantly more favorable survival compared with the noncutaneous stage I ENKTL (P=.037). These results suggest that PCNKTL constitute a distinct subgroup in the nasal-type lymphoma spectrum.
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Affiliation(s)
- Chun-Chieh Wu
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan 807; Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan 466-8560
| | - Emiko Takahashi
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan 480-1195
| | - Naoko Asano
- Department of Molecular Diagnostics, Nagano Prefectural Suzaka Hospital, Suzaka, Japan 382-0091
| | - Tomoko Miyata-Takata
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan 700-8558
| | - Katsuyoshi Takata
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan 700-8558; Centre for Lymphoid Cancer, BC Cancer Agency, Department of Pathology, British Columbia Cancer Research Centre, Vancouver, BC, V5Z 1L3 Canada
| | - Katsuya Furukawa
- Department of Hematology, Ogaki Municipal Hospital, Ogaki, Japan 503-8502
| | - Ahmed Ali Elsayed
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan 466-8560; Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt 35516
| | - Lei-Ming Hu
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan 466-8560; Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan 466-8560
| | - Akira Satou
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan 466-8560; Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan 480-1195
| | - Kei Kohno
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan 466-8560
| | - Hiroshi Kosugi
- Department of Hematology, Ogaki Municipal Hospital, Ogaki, Japan 503-8502
| | - Kenichi Ohashi
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan 236-0016
| | - Tomohiro Kinoshita
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan 464-8681
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan 466-8560
| | - Seiichi Kato
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan 466-8560; Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan 464-8681.
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Chuang SS, Ko YH. Cutaneous nonmycotic T- and natural killer/T-cell lymphomas: Diagnostic challenges and dilemmas. J Am Acad Dermatol 2014; 70:724-735. [DOI: 10.1016/j.jaad.2013.11.047] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 11/15/2013] [Accepted: 11/19/2013] [Indexed: 11/17/2022]
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Gridley DS, Mao XW, Stodieck LS, Ferguson VL, Bateman TA, Moldovan M, Cunningham CE, Jones TA, Slater JM, Pecaut MJ. Changes in mouse thymus and spleen after return from the STS-135 mission in space. PLoS One 2013; 8:e75097. [PMID: 24069384 PMCID: PMC3777930 DOI: 10.1371/journal.pone.0075097] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 08/08/2013] [Indexed: 11/21/2022] Open
Abstract
Our previous results with flight (FLT) mice showed abnormalities in thymuses and spleens that have potential to compromise immune defense mechanisms. In this study, the organs were further evaluated in C57BL/6 mice after Space Shuttle Atlantis returned from a 13-day mission. Thymuses and spleens were harvested from FLT mice and ground controls housed in similar animal enclosure modules (AEM). Organ and body mass, DNA fragmentation and expression of genes related to T cells and cancer were determined. Although significance was not obtained for thymus mass, DNA fragmentation was greater in the FLT group (P<0.01). Spleen mass alone and relative to body mass was significantly decreased in FLT mice (P<0.05). In FLT thymuses, 6/84 T cell-related genes were affected versus the AEM control group (P<0.05; up: IL10, Il18bp, Il18r1, Spp1; down: Ccl7, IL6); 15/84 cancer-related genes had altered expression (P<0.05; up: Casp8, FGFR2, Figf, Hgf, IGF1, Itga4, Ncam1, Pdgfa, Pik3r1, Serpinb2, Sykb; down: Cdc25a, E2F1, Mmp9, Myc). In the spleen, 8/84 cancer-related genes were affected in FLT mice compared to AEM controls (P<0.05; up: Cdkn2a; down: Birc5, Casp8, Ctnnb1, Map2k1, Mdm2, NFkB1, Pdgfa). Pathway analysis (apoptosis signaling and checkpoint regulation) was used to map relationships among the cancer–related genes. The results showed that a relatively short mission in space had a significant impact on both organs. The findings also indicate that immune system aberrations due to stressors associated with space travel should be included when estimating risk for pathologies such as cancer and infection and in designing appropriate countermeasures. Although this was the historic last flight of NASA’s Space Shuttle Program, exploration of space will undoubtedly continue.
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Affiliation(s)
- Daila S. Gridley
- Department of Basic Sciences, Division of Radiation Research, Loma Linda University, Loma Linda, California, United States of America
- * E-mail:
| | - Xiao Wen Mao
- Department of Basic Sciences, Division of Radiation Research, Loma Linda University, Loma Linda, California, United States of America
| | - Louis S. Stodieck
- BioServe Space Technologies, Aerospace Engineering Sciences, University of Colorado, Boulder, Colorado, United States of America
| | - Virginia L. Ferguson
- Department of Mechanical Engineering, University of Colorado, Boulder, Colorado, United States of America
| | - Ted A. Bateman
- Department of Bioengineering, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Maria Moldovan
- Department of Basic Sciences, Division of Radiation Research, Loma Linda University, Loma Linda, California, United States of America
| | - Christopher E. Cunningham
- Department of Basic Sciences, Division of Radiation Research, Loma Linda University, Loma Linda, California, United States of America
| | - Tamako A. Jones
- Department of Basic Sciences, Division of Radiation Research, Loma Linda University, Loma Linda, California, United States of America
| | - Jerry M. Slater
- Department of Basic Sciences, Division of Radiation Research, Loma Linda University, Loma Linda, California, United States of America
| | - Michael J. Pecaut
- Department of Basic Sciences, Division of Radiation Research, Loma Linda University, Loma Linda, California, United States of America
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Yu WW, Hsieh PP, Chuang SS. Cutaneous EBV-positive γδ T-cell lymphoma vs. extranodal NK/T-cell lymphoma: a case report and literature review. J Cutan Pathol 2012; 40:310-6. [DOI: 10.1111/cup.12066] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 11/12/2012] [Accepted: 11/17/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Wei-Wen Yu
- Department of Dermatology; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
- Department of Pathology and Laboratory Medicine; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
| | - Pin-Pen Hsieh
- Department of Pathology and Laboratory Medicine; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
- Center for General Education; Yuh-Ing Junior College of Health Care and Management; Kaohsiung Taiwan
| | - Shih-Sung Chuang
- Department of Pathology; Chi-Mei Medical Center; Tainan Taiwan
- Department of Pathology; Taipei Medical University; Taipei Taiwan
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