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Aggressive natural killer cell lymphoma/leukemia.

Po-Shing Lee1, Wei-Shou Hwang

  • 1Department of Pathology, Chi Mei Foundation Medical Center, Tainan, Taiwan, ROC. leeposhing@hotmail.com

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|March 15, 2003
PubMed
Summary
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A rare aggressive natural killer (NK) cell lymphoma/leukemia case in an elderly woman presented with systemic symptoms and elevated CA19-9. Epstein-Barr virus (EBV) was detected, highlighting aggressive NK cell neoplasms.

Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Aggressive natural killer (NK) cell lymphoma/leukemia is a rare and aggressive hematologic malignancy.
  • Early diagnosis and understanding of its characteristics are crucial for patient outcomes.

Observation:

  • A 70-year-old woman presented with fever, enlarged liver and spleen, retroperitoneal lymphadenopathy, and elevated CA19-9.
  • Neoplastic NK cells were detected in peripheral blood and retroperitoneal lymph node biopsy.
  • Epstein-Barr virus-associated RNA (EBER) in situ hybridization was positive in neoplastic cells.

Findings:

  • Flow cytometry and immunohistochemistry confirmed the phenotype of neoplastic NK cells.
  • The patient was diagnosed with aggressive NK cell lymphoma/leukemia.

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  • The patient had a rapid clinical course, succumbing to the disease 4 days post-diagnosis.

    • Implications:

    • This case underscores the importance of considering aggressive NK cell lymphoma/leukemia in the differential diagnosis of elderly patients with unexplained systemic symptoms and elevated tumor markers.
    • The positive EBER in situ hybridization suggests a potential role for Epstein-Barr virus in the pathogenesis of this aggressive NK cell neoplasm.
    • Further research into the molecular mechanisms and therapeutic strategies for EBV-associated aggressive NK cell neoplasms is warranted.