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Han Y, Wei S, Zhang Y, Wang L, Xu X. Extranodal nasal-type NK/T-cell lymphoma with CD20 positive: A case report and review of literature. INDIAN J PATHOL MICR 2024; 67:459-462. [PMID: 38391360 DOI: 10.4103/ijpm.ijpm_32_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 05/08/2022] [Indexed: 02/24/2024] Open
Abstract
ABSTRACT Extranodal nasal-type natural killer (NK)/T-cell lymphoma is a type of non-Hodgkin lymphoma. Neoplastic lymphocytes are positive for CD4, CD56, and CD20, a specific B-cell marker. CD20 positive NK/T-cell lymphoma is rare, with only nine reported cases. This paper reports a case of nasal-type NK/T-cell lymphoma with CD20 positivity in a 47-year-old woman. The patient presented with bilateral nasal congestion and bloody nasal cavity secretions for 2 months. Computed tomography revealed thickening of the nasal mucosa and posterior wall of the nasopharyngeal crest, and the left and right cervical lymph nodes were enlarged. On histopathology, the lesion was composed of medium-sized atypical lymphoid cells and vascular infringement. Immunohistochemical staining showed that the tumor cells were positive for CD20, CD3, CD56, and Epstein-Barr virus (EBV)-encoded RNA in situ hybridization. The patient was treated with radiotherapy for 2 months and is currently well.
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Affiliation(s)
- Yongliang Han
- Department of Pathology, Jiujiang No. 1 People's Hospital, Jiujiang, China
| | - Shufei Wei
- Department of Pathology, Jiujiang University Hospital, Jiujiang, China
| | - Yihang Zhang
- Department of Radiology, Jiujiang University Hospital, Jiujiang, China
| | - Liangliang Wang
- Department of Pathology, Jiujiang University Hospital, Jiujiang, China
| | - Xiao Xu
- Department of Pathology, Jiujiang University Hospital, Jiujiang, China
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Zhao B, Kim HJ, Tam L, Xiong W, Rosenfeld G. A Rare Case of Gastric Extranodal NK/T-Cell Lymphoma With Orbital Involvement. ACG Case Rep J 2024; 11:e01280. [PMID: 38425941 PMCID: PMC10901430 DOI: 10.14309/crj.0000000000001280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/15/2024] [Indexed: 03/02/2024] Open
Abstract
Gastric extranodal NK/T-cell lymphoma (ENKTL) is a rare presentation of a rare disease. We report a 33-year-old woman presenting with epigastric pain, nausea, and vomiting. Endoscopic examination revealed gastric and duodenal ulceration. Biopsy of the ulcers revealed ENKTL. The patient began treatment, but developed hemorrhagic shock from her ulcers and died. Gastric ENKTL is a rare disease that presents with gastric ulceration. It has a high rate of mortality, and treatment is challenging because of its aggressive nature and lack of high-quality data to guide therapy.
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Affiliation(s)
- Billy Zhao
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hyun Jae Kim
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Landon Tam
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wei Xiong
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Greg Rosenfeld
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
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3
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Li DJ, Kan YZ, Xu ZG, Kang H, Dong XM, Kong LF. [Extranodal nasal-type natural killer/T-cell lymphoma with aberrant expression of CD20: two cases report and literature review]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2020; 41:336-339. [PMID: 32447942 PMCID: PMC7364918 DOI: 10.3760/cma.j.issn.0253-2727.2020.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Indexed: 11/25/2022]
Affiliation(s)
- D J Li
- Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou 450003, China
| | - Y Z Kan
- Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou 450003, China
| | - Z G Xu
- Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou 450003, China
| | - H Kang
- Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou 450003, China
| | - X M Dong
- Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou 450003, China
| | - L F Kong
- Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou 450003, China
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Li D, Fu F, Lian L. Primary central nervous system extranodal nasal-type natural killer/T-cell lymphoma with CD20 expression. Neuropathology 2017; 38:198-204. [PMID: 29063643 DOI: 10.1111/neup.12438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/29/2017] [Accepted: 09/30/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Dujuan Li
- Department of Pathology; Henan Provincial People's Hospital (People's Hospital of Zhengzhou University); Zhengzhou China
| | - Fangfang Fu
- Department of Radiology; Henan Provincial People's Hospital (People's Hospital of Zhengzhou University); Zhengzhou China
| | - Lifei Lian
- Department of Neurology, Tongji Hospital, Tongji Medical College; Huazhong University of Science and Technology; Wuhan China
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Zhang L, Zhang P, Wen J, Chen X, Zhang H. Primary gastric natural killer/T-cell lymphoma with diffuse CD30 expression and without CD56 expression: A case report. Oncol Lett 2016; 11:969-972. [PMID: 26893677 PMCID: PMC4734030 DOI: 10.3892/ol.2015.4015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 11/20/2015] [Indexed: 11/26/2022] Open
Abstract
The majority of natural killer (NK)/T-cell lymphomas occur in the nasal cavity and rarely involve the stomach. They possess a specific immunophenotype, with the expression of cluster of differentiation (CD)56, CD2 and CD3ε, but without CD3 expression. Few cases of NK/T-cell lymphoma have partial CD30 expression. The present study reveals a unique case of a 41-year-old female patient with gastric NK/T-cell lymphoma that did not express CD56 and diffusely expressed CD30. Immunohistochemical staining demonstrated that the tumor cells expressed CD3ε, CD43, CD30 and granzyme B and did not express CD2, CD4, CD5, CD7, CD8, CD56, anaplastic lymphoma kinase, CD20, paired box-5 or pan cytokeratin. Based on the immunostaining profile and morphological features, the initial diagnosis considered was gastric anaplastic large cell lymphoma. However, following a consultation with other pathologists, the Epstein-Barr virus (EBV) status of the patient was investigated to exclude a diagnosis of NK/T-cell lymphoma. Notably, the signal for EBV RNA was diffuse positive. Therefore, the final diagnosis was corrected to NK/T-cell lymphoma. To the best of our knowledge, the present study is the first to report NK/T-cell lymphoma in the stomach with a diffuse CD30-positive and CD56-negative phenotype.
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Affiliation(s)
- Lizhi Zhang
- Department of Pathology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Pengxin Zhang
- Department of Pathology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Jinhui Wen
- Department of Geratology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Xuehua Chen
- Department of Geratology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Hua Zhang
- Department of Geratology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
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Vetro C, Bonanno G, Giulietti G, Romano A, Conticello C, Chiarenza A, Spina P, Coppolino F, Cunsolo R, Raimondo FD. Rare gastrointestinal lymphomas: The endoscopic investigation. World J Gastrointest Endosc 2015; 7:928-949. [PMID: 26265987 PMCID: PMC4530327 DOI: 10.4253/wjge.v7.i10.928] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/01/2015] [Accepted: 07/09/2015] [Indexed: 02/05/2023] Open
Abstract
Gastrointestinal lymphomas represent up to 10% of gastrointestinal malignancies and about one third of non-Hodgkin lymphomas. The most prominent histologies are mucosa-associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma. However, the gastrointestinal tract can be the site of rarer lymphoma subtypes as a primary or secondary localization. Due to their rarity and the multifaceted histology, an endoscopic classification has not been validated yet. This review aims to analyze the endoscopic presentation of rare gastrointestinal lymphomas from disease diagnosis to follow-up, according to the involved site and lymphoma subtype. Existing, new and emerging endoscopic technologies have been examined. In particular, we investigated the diagnostic, prognostic and follow-up endoscopic features of T-cell and natural killer lymphomas, lymphomatous polyposis and mantle cell lymphoma, follicular lymphoma, plasma cell related disease, gastrointestinal lymphomas in immunodeficiency and Hodgkin’s lymphoma of the gastrointestinal tract. Contrarily to more frequent gastrointestinal lymphomas, data about rare lymphomas are mostly extracted from case series and case reports. Due to the data paucity, a synergism between gastroenterologists and hematologists is required in order to better manage the disease. Indeed, clinical and prognostic features are different from nodal and extranodal or the bone marrow (in case of plasma cell disease) counterpart. Therefore, the approach should be based on the knowledge of the peculiar behavior and natural history of disease.
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Huang YH, Huang CT, Tan SY, Chuang SS. Primary gastric extranodal natural killer/T-cell lymphoma, nasal type, with acquisition of CD20 expression in the subcutaneous relapse: report of a case with literature review. J Clin Pathol 2015; 68:943-5. [PMID: 26142362 DOI: 10.1136/jclinpath-2015-203188] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 06/15/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Yu-Hua Huang
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Chien-Tai Huang
- Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Soo Yong Tan
- Department of Pathology, Singapore General Hospital and Singhealth Tissue Repository, Singapore Health Services, Singapore, Singapore
| | - Shih-Sung Chuang
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan Department of Pathology, College of Medicine, Taipei Medical University and National Taiwan University, Taipei, Taiwan
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Mahuad CV, Bilbao ER, Garate GM, de Los Ángeles Vicente Repáraz M, Del Olmo M, Casali CÉ, Zerga ME, Chirife AM, Cicco JA. Primary NK/T cell lymphoma nasal type of the colon. Rare Tumors 2013; 5:e9. [PMID: 23772308 PMCID: PMC3682461 DOI: 10.4081/rt.2013.e9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 01/25/2013] [Accepted: 01/26/2013] [Indexed: 11/22/2022] Open
Abstract
Since nasal NK/T-cell lymphoma and NK/T-cell lymphoma nasal type are rare diseases, colonic involvement has seldom been seen. We report a case of a patient with a primary NK/T-cell lymphoma nasal type of the colon. The patient had no history of malignant diseases and was diagnosed after exhaustive study in the context of fever of unknown origin. The first therapeutic approach followed the DA-EPOCH-protocol: etoposide, prednisone, doxor-rubicin, vincristine and cyclophosphamide. The persistence of constitutional symptoms after the first treatment course motivated the switch to a second line following the SMILE-protocol: dexamethasone, metotrexate, ifosfamide, E.coli L-asparaginase, and etoposide. Despite intensive chemotherapy, the patient died 2 months after the diagnose of an extranodal NK/T-cell lymphoma of the colon and 4 months after the first symptomatic appearance of disease.
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Terai T, Sugimoto M, Uozaki H, Kitagawa T, Kinoshita M, Baba S, Yamada T, Osawa S, Sugimoto K. Lymphomatoidgastropathy mimicking extranodal NK/T cell lymphoma, nasal type: A case report. World J Gastroenterol 2012; 18:2140-4. [PMID: 22563204 PMCID: PMC3342615 DOI: 10.3748/wjg.v18.i17.2140] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 02/20/2012] [Accepted: 02/26/2012] [Indexed: 02/06/2023] Open
Abstract
Extranodal natural killer (NK)/T-cell lymphoma, nasal type, exhibits aggressive tumor behavior and carries a poor prognosis. Recently, lymphomatoid gastropathy with NK/T cell infiltration into gastric mucosa has been recognized as a pseudo-malignant disease which regresses without treatment. Because the conventional immunohistochemical criteria of lymphomatoid gastropathy is similar to that of extranodal NK/T-cell lymphoma nasal type, it is difficult to distinguish between the two conditions by histopathological evaluation only. Here, we report a rare case of lymphomatoid gastropathy in a 57-year-old female. Gastroendoscopy on routine check-up revealed elevated reddish lesions < 1 cm in diameter in the gastric fornix and body. Although repeat endoscopies at 1 and 6 mo later revealed no gastric lesions at any locations without any treatments, at 12 mo later gastric lymphomatoid lesions recurred at gastric fornix and body. Histological examination of endoscopic biopsy specimens at 12 mo showed atypical NK cell infiltration with CD3+, CD4-, CD5-, CD7+, CD8-, CD20-, CD30-, CD56+, CD79a- and T-cell-restricted intracellular antigen-1+ into gastric mucosa. After treatment for Helicobacter pylori (H. pylori) eradication, the lesions disappeared in all locations of the gastric fornix and body over the subsequent 12 mo. Here, we report a case of H. pylori-positive lymphomatoid gastropathy with massive NK-cell proliferation, and also review the literature concerning newly identified lymphomatoid gastropathy based on comparison of extra nodal NK/T-cell lymphoma nasal type. In any case, these lesions are evaluated with biopsy specimens, the possibility of this benign entity should be considered, and excessive treatment should be carefully avoided. Close follow-up for this case of lymphomatoid gastropathy is necessary to exclude any underlying malignancy.
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