Immunomorphologic profile and Epstein–Barr virus status of a cohort of 35 cases of extranodal natural killer/T-cell lymphoma, nasal type of upper aerodigestive tract from a tertiary care center in South India

Abstract

Extranodal natural killer (NK)/T-cell lymphoma, nasal type (EN-NK/T-NT) is a lymphoma of NK-cell or cytotoxic T-cell origin, which occurs most commonly in the upper aerodigestive tract. We have studied the immunomorphologic profile and Epstein-Barr virus (EBV) status of a cohort of 35 cases of EN-NK/T-NT of the upper aerodigestive tract (UADT) diagnosed in our institution during the period May 2002 to April 2012. At our institution these lymphomas constitute 0.7% of total non-Hodgkin lymphomas (NHLs) and 5.1% of total peripheral T-cell lymphomas (PTCLs). The median age at diagnosis was 40 years with a male-to-female ratio of 4:1, and the most common site of involvement was the nasal cavity. Morphologically, the neoplastic cells were predominantly medium sized in most cases. Necrosis and angiocentricity were common histologic features. Thirty cases (85.7%) showed NK-cell immunophenotype, CD3+ (29/30, 96.7%), CD56+ (30/30, 100%) and TIA1/Granzyme B+ (30/30, 100%). Five cases (14.3%) showed cytotoxic T-cell immunophenotype, CD3+ (5/5, 100%), CD56- (5/5, 100%) and TIA1/Granzyme B+ (5/5, 100%). EBV-encoded RNA-in situ hybridization (EBER-ISH) was positive in all 35 cases, whereas EBV latent membrane protein-1 (EBVLMP1) was positive in only 19/35 (54.3%) of cases. In conclusion, this is the first large study from India to report the immunomorphologic profile and EBV association of EN-NK/T-NT, which is known to have geographic variation. The frequency of these lymphomas in our study is comparable to that of Western and European countries and much less than that of Far Eastern countries.

Genotypic analysis and latent membrane protein 1 expression of Epstein-Barr virus in extranodal NK/T-cell lymphoma from Northern Chinese patients

“…In our study, the LMP1 expression level was high in ENKTL patients, which is consistent with the previous studies. This result suggests that LMP1 is a crucial oncogenic protein that participates in the pathogenesis of ENKTL [25]. Although men are more frequently affected than women, and the majority of patients are adults [40 years old, there was no relationship between the gender and age with LMP1 expression in the present study.…”

NK/T Cell Lymphoma: A Tertiary Centre Experience

“…Of the only 2 large series comprising of 37 cases and 84 cases of ENKTCL described from India, only one study has actually documented the ethnicity of the patients with these neoplasms. Almost half of the cases in that study were from western India where as East India (West Bengal/Assam) constituted 20 % of the overall ENKTCL [7,8].…”

Atypical lymphoid proliferations: the pathologist’s viewpoint

“…The latter are positive for CD2, CD43 and NK-cell antigen CD56; negative for CD3, CD5, CD57 and CD11. Large groups of Epstein-Barr virus-encoded RNA-positive cells and high proliferative fraction in the atypical cells (Ki-67 more than 80%) are seen in NK/T-cell lymphomas [77,78]. Clues favoring AtLP are the absence of EBV-positive cells and possible detection of some etiological agents (microorganisms).…”