Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Feb 17:2018:bcr2017221019.
doi: 10.1136/bcr-2017-221019.

Late diagnosis: a case of rapidly progressive extranodal NK/T cell lymphoma, nasal type

Hiroyuki Mori  1 , Kei Ebisawa  1 , Mitsushige Nishimura  2 , Kenji Kanazawa  3
Affiliations
Case Reports

Late diagnosis: a case of rapidly progressive extranodal NK/T cell lymphoma, nasal type

Hiroyuki Mori et al. BMJ Case Rep. .

Abstract

Extranodal natural killer (NK)/T cell lymphoma, nasal type is a condition that has poor prognosis. Accurate diagnosis of lymphoma is made by pathological findings. We report a case of extranodal NK/T cell lymphoma, nasal type affecting the lung and liver and which was difficult to diagnose because of negative biopsy results from multiple sites. A 39-year-old man who had dry cough and fever for 1 month was referred to our hospital. He had pancytopenia and elevated serum levels of lactate dehydrogenase and soluble interleukin-2 receptor. Hepatosplenomegaly and multiple lung nodules were found on imaging study. Specimens of bronchoscopic lung, percutaneous liver, bone marrow and random skin biopsies were all negative. Open lung biopsy was not definitive. Unfortunately, disease progression was rapid and fatal before results of pleural fluid cytology and a second liver biopsy showed extranodal NK/T cell lymphoma, nasal type. This report focused on diagnostic planning for rapidly progressive extranodal NK/T-cell lymphoma, nasal type.

Keywords: malignant and benign haematology; medical management.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Chest X-ray showing multiple nodular lesions bilaterally.
Figure 2
Figure 2
Chest CT imaging showing multiple nodular lesions bilaterally.
Figure 3
Figure 3
Abdominal CT imaging showing hepatosplenomegaly.
Figure 4
Figure 4
(A) Pleural effusion micropathology showing immature lymphocytes with irregular karyotype. (B) Liver micropathology showing immature lymphocytes with irregular karyotype.
Figure 5
Figure 5
Immunohistochemical staining of pleural effusion showing positive for CD3, CD56 and Epstein-Barr encoding region (EBER), but negative for CD20.
See this image and copyright information in PMC

References

    1. Chien CC, Lee HS, Lin MH, et al. . Primary extranodal natural killer/T-cell lymphoma of bronchus and lung: a case report and review of literature. Thorac Cancer 2016;7:140–4. 10.1111/1759-7714.12254 - DOI - PMC - PubMed
    1. Lee S, Shin B, Yoon H, et al. . A case of primary pulmonary NK/T cell lymphoma presenting as pneumonia. Respir Med Case Rep 2016;17:1–4. 10.1016/j.rmcr.2015.11.003 - DOI - PMC - PubMed
    1. Liu CH, Wang HH, Perng CL, et al. . Primary extranodal NK/T-cell lymphoma of the lung: mimicking bronchogenic carcinoma. Thorac Cancer 2014;5:93–6. 10.1111/1759-7714.12021 - DOI - PMC - PubMed
    1. Mizuki M, Ueda S, Tagawa S, et al. . Natural killer cell-derived large granular lymphocyte lymphoma of lung developed in a patient with hypersensitivity to mosquito bites and reactivated epstein-barr virus infection. Am J Hematol 1998;59:309–15. 10.1002/(SICI)1096-8652(199812)59:4<309::AID-AJH7>3.0.CO;2-B - DOI - PubMed
    1. Oshima K, Tanino Y, Sato S, et al. . Primary pulmonary extranodal natural killer/T-cell lymphoma: nasal type with multiple nodules. Eur Respir J 2012;40:795–8. 10.1183/09031936.00123911 - DOI - PubMed

Publication types