NK/T-cell lymphoma of bilateral adrenal glands in a patient with pyothorax

Tsukahara, Tomohide; Takasawa, Akira; Murata, Masaki; K, Okumura; Nakayama, Masato; Sato, Noriyuki; Hasegawa, Tadashi

doi:10.1186/1746-1596-7-114

Cited by 13 publications

(13 citation statements)

References 12 publications

(10 reference statements)

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“…NK/T-cell lymphomas that express CD30, with or without CD56 expression, have been reported in previous studies in the nasal cavity, spleen, prostate and adrenal glands ( 7 – 10 , 18 – 20 ). However, to the best of our knowledge, no studies have reported this NK/T-cell lymphoma phenotype occurring in the stomach.…”

Section: Discussionsupporting

confidence: 54%

“…In the present study, the tumor cells possessed irregular kidney-shaped nuclei, which expressed CD3ε and diffusely expressed CD30, but did not express CD56, therefore leading to an initial diagnosis of ALCL. However, there have been studies reporting NK/T-cell lymphoma in the nasal cavity, prostate, spleen and adrenal glands, where the tumor expresses CD30, with or without CD56 expression ( 7 – 10 ). To the best of our knowledge, no studies have reported this type of lymphoma in the stomach.…”

Section: Discussionmentioning

confidence: 99%

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Primary gastric natural killer/T-cell lymphoma with diffuse CD30 expression and without CD56 expression: A case report

Zhang

Wen

et al. 2015

Oncology Letters

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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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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Primary gastric natural killer/T-cell lymphoma with diffuse CD30 expression and without CD56 expression: A case report

Zhang

Wen

et al. 2015

Oncology Letters

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“…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].…”

Section: Discussionmentioning

confidence: 99%

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

2018

IJCRT

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Extranodal NK/T cell lymphoma, nasal type is a rare, clinically aggressive, locally destructive and necrotizing disease. It represents 7-10% of all non-Hodgkin lymphomas with a 1-year survival rate of 40%. This case will be the first reported case in the Philippines. We report 44 year old Filipino male who presented with one year history of foul smelling left nasal discharge. Physical examination was unremarkable except for ~1 x 1 cm cavity at the soft palate. Several consult done, given nasal drops and antibiotics with no relief of symptoms. Nasopharyngeal CT scan revealed a 5.2 x 3.1 cm soft tissue mass at left nasal cavity extending into the contralateral nasal cavity, no intracranial extension. After three unremarkable nasal biopsies, histopathology revealed round cell neoplasm, with immunohistochemical stains consistent with NK/T cell lymphoma Nasal type localized disease. Metastatic work up were all unremarkable. He then underwent concurrent chemotherapy with Cisplatin and radiotherapy (30cGY). The palatal cavity increased in size to 3 x 3 cm after completion of radiotherapy, however the soft tissue mass decreased in size hence three cycles of VIPD (etoposide, ifosfamide, cisplatin, dexamethasone) was given. Patient remained asymptomatic, with a good performance score. Nasal endoscopy and nasopharyngeal MRI done post-treatment showed no evidence of lesion with stable palatal cavity defect. CT scan of chest however revealed a left upper lobe non-calcified 2cm nodule with bilateral subpleural nodules. In a rare yet aggressive malignancy such as NK/T cell lymphoma wherein the primary lesion had good response to treatment, a new lung lesion could impose progressive disease such as metastasis. We could either treat patient as a case of progressive disease and subject him to a battery of chemotherapy or we could biopsy the new lesion. Either way, delay in diagnosis cause undue anxiety and uncanny cost to patient. In our case, biopsy was done and indeed it was of infectious in origin. The malignancy responded well to treatment.

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“…Meanwhile, morphologically, middle to large-sized neoplastic cells with atypia and mitosis can be detected in T cell lymphoma and ANKL. However, as previously mentioned, the characteristic T-cell makers, rearranged TCR gene, and have no relation to EBV infection are distinguishing features [14,15]. …”

Section: Discussionmentioning

confidence: 99%

Aggressive natural killer-cell leukemia with jaundice and spontaneous splenic rupture: a case report and review of the literature

et al. 2013

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Aggressive natural killer cell leukemia/lymphoma (ANKL) is a rare aggressive form of NK-cell neoplasm. We report an uncommon case of 36-year-old male who showed jaundice and spontaneous splenic rupture. The diagnosis was established by the biopsy of liver and spleen. The monomorphous medium-size neoplastic cells infiltrated into portal areas and sinus of liver as well as the cords and sinus of the spleen. Necrosis, mitotic figures and significant apoptosis could be seen easily. These neoplastic cells demonstrated a typical immunophenotype of CD3ε+, CD56+, CD16+, Granzyme B+, TIA-1+. T-cell receptor γ (TCR-γ) gene rearrangement analysis showed germline configuration and the result of in situ hybridization for Epstein-Barr virus-encoded RNA (EBER-ISH) was positive. The patient has undergone an aggressive clinical course and died of multi-organ function failure 14 days later after admission. To the best of our knowledge, this is the first case of ANKL with spontaneous splenic rupture, and we should pay more attention to recognize it.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2048154883890867

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NK/T-cell lymphoma of bilateral adrenal glands in a patient with pyothorax

Cited by 13 publications

References 12 publications

Primary gastric natural killer/T-cell lymphoma with diffuse CD30 expression and without CD56 expression: A case report

Primary gastric natural killer/T-cell lymphoma with diffuse CD30 expression and without CD56 expression: A case report

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

Aggressive natural killer-cell leukemia with jaundice and spontaneous splenic rupture: a case report and review of the literature

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