CD-3 positive extranodal T-cell lymphoma of nasal type with skin involvement

Abstract

A 40-year-old previously healthy lady presented with nasal obstruction and localized plaques over the right arm. She developed complete nasal obstruction due to a mass in the right nasal cavity and skin lesions that ulcerated to present as ecthyma gangrenosum like lesions. Patient's condition deteriorated fast and she developed icterus with fatal outcome within 4 weeks of developing skin lesions. Nasal and skin biopsy revealed angiocentric T-cell lymphoma, which on immuno-phenotyping revealed CD-3 positive; and CD-20, CD-30, ALK and EMA negativity. She was seronegative for HIV. Final diagnosis of CD-3 positive extranodal T-cell lymphoma of nasal type was made. Extranodal T-cell lymphomas are very aggressive NHLs with poor prognosis. Prognosis depends on histology, stage of the disease and sites of involvement. NK/T cell lymphoma of nasal type is common with EBV association. Skin involvement is rare and is also an indicator of poor prognosis.

Extranodal T-Cell Lymphoma of Nasal Cavity

“…Apart from the nasal cavity, other sites of involvement are skin, gut, testis [8] breast [9], kidney, upper respiratory tract and rarely eye. The usual histological type of large cell lymphoma of nasal type which on immunohistochemistry usually turn out to be T-cell lineage [10]. Non-Hodgkin's lymphoma have a high cure and survival rate with early diagnosis and staging with appropriate treatment.…”