Intraoral Extranodal Natural Killer Cell/T-Cell Lymphoma of the Hard Palate

Natural killer cell/T-cell lymphoma (NK/TL) is a rare subtype of non-Hodgkin's lymphoma (NHL) associated with the Epstein-Barr virus (EBV) and requires early detection, which can be very challenging. NK/TL often arises in the nasal cavity and can then spread to the oral cavity, but the case presented here is an unusual presentation of NK/TL in a 66-year-old edentulous male patient who initially presented an intraoral exophytic lesion in the palate that appeared within 3 months. We report the present case to highlight the challenges of reaching an accurate diagnosis given the diverse clinical manifestations of NK/TL.

The value of fourth and subsequent post-treatment 18F-FDG PET/CT scans in the management of patients with non-Hodgkin's lymphoma

OBJECTIVE

To evaluate the impact of fourth and subsequent follow-up PET/computed tomography (PET/CT) scans in patients with non-Hodgkins lymphoma (NHL).

MATERIALS AND METHODS

This retrospective study evaluated all biopsy-proven NHL patients who had more than three follow-up scans after completion of primary treatment from 2000 to 2013 at our academic center. Among 586 patients with NHL who had at least one fluorine-18 fluorodeoxyglucose (F-FDG) PET/CT scan at our institution, a total of 77 patients with 208 fourth and subsequent follow-up F-FDG PET/CT scans, were included in the study. The impact of these follow-up scans on the clinical assessment and the management of the patients was evaluated.

RESULTS

Among 208 fourth and subsequent follow-up scans, 33 were performed with a previous clinical suspicion of recurrence and 175 were performed without a previous clinical suspicion of recurrence. Fourth and subsequent follow-up PET/CT results were useful in excluding tumor in 27.3% of scan times when there was a clinical suspicion of recurrence and in identifying recurrence in 5.1% of scan times when there was no previous clinical suspicion of recurrence. Clinicians changed management after 36.4% (12/33) scans that were performed with previous clinical suspicion of recurrence and 9.2% (16/175) scans that were performed without previous clinical suspicion (P=0.001).

CONCLUSION

Fourth and subsequent follow-up PET/CT scans affect the treatment and management of patients with NHL and add value to clinical assessment and management, especially in patients with a previous clinical suspicion of recurrence.