An extraordinary T/NK lymphoma, nasal type, occurring primarily in the prostate gland with unusual CD30 positivity: case report and review of the literature

Abstract

Extranodal NK/T cell lymphoma(NKTCL), nasal type, occurring primarily in the prostate gland, is extremely rare. We present a case of primarily prostatic NKTCL in a 59-year-old man suffering from dysuria. Histological examinations revealed that diffused, large-sized, pleomorphic lymphocytes were arranged in an angiocentric distribution with large areas of geographic necroses. Additionally, the prostatic glands were diffusely infiltrated by heteromorphous lymphocytes forming lymphoepithelial lesions. The tumor cells were strongly expressed CD3ϵ, CD56, TIA-1, granzyme B and EBV-encoded RNAs. And interestingly, the lymphoid cells were also strongly immunoreactive with CD30. A rearrangement study showed T-cell receptor γ-chain gene rearrangement with monoclonal appearance. Though postoperative combination of chemotherapy was given, the patient died four months later. Our observation and other literatures indicate that extremely rare NKTCLs unusually express CD30. TCR gene rearrangement existed in some NKTCL, suggesting that a subset of NKTCL may be a mixed NK/T-cell differentiation.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9671878568932824.

Extranodal NK/T Cell Lymphoma, Nasal Type (ENKTL-NT): An Update on Epidemiology, Clinical Presentation, and Natural History in North American and European Cases

“…Hemophagocytosis is observed in up to 3% of cases 36,46–63 and hydroa vacciniforme-like lymphoproliferative disorder (HVLL), an indolent lymphoproliferative disorder of EBV+ NK-cells or γ/δ T-cells can precede ENKTL-NT by several years. 64 There is no evidence of HVLL preceding ENKTL-NT in U.S. or European ENKTL-NT.…”

Malignant effusions from extranodal NK/T‐cell lymphomas are frequently of anaplastic morphology with azurophilic granules and of T‐cell lineage

“…This expression rate is higher than the 30% in the WHO book of ENKTL . In de novo ENKTL, large cell morphology usually correlates with CD30 expression; and in some studies, a poorer prognosis . In this current study, the lymphoma cells of effusion ENKTL are usually large and anaplastic, which is distinct from de novo ENKTL.…”

“…10 Radiologic studies showed no evidence of lymphadenop- In de novo ENKTL, large cell morphology usually correlates with CD30 expression; and in some studies, a poorer prognosis. [35][36][37] In this current study, the lymphoma cells of effusion ENKTL are usually large and anaplastic, which is distinct from de novo ENKTL. We recommend that CD30 immunostaining be performed for all effusion ENKTL cases; and target therapy with brentuximab vedotin, an anti-CD30 antibody-drug conjugate, might be considered a therapeutic option for those with CD30-expressing tumors.…”

NK/T Cell Lymphoma, Nasal Type: a Case Report

“…Extranodal NK/T-cell lymphomas characteristically involve the upper aerodigestive tract, with the nasal cavity being the prototypic site [3]. Rarely, the tumour occurs in prostate, adrenal glands and lung [4][5][6]. According the WHO criterion, the neoplastic lymphoid cells usually co-express NK cell markers such as CD56 and T cellassociated antigens like CD3, CD2 with expression of cytotoxic markers such as TIA-1, Perforin and Granzyme-B [6].…”