Natural killer/T-cell nasal-type lymphoma: unusual primary spinal tumor

A natural killer/T-cell lymphoma originating in the spine of a 60-year-old man is first reported, along with a brief review of the literature on the topic.

To describe the presentation and diagnosis of this disorder along with an emphasis on the importance of this type of rare tumor, needing early and accurate immunophenotypic profiling to make a right diagnosis.

Natural killer (NK)/T-cell lymphomas represent a rare type of lymphoma derived from either activated NK cell or rarely cytotoxic T cells. It usually originates in the nasal cavity/nasopharynx and invades the surrounding tissues, which is aggressive and, usually, a delay in diagnosis could result in a fatal outcome.

A 60-year-old man presented with severe pain in his chest and back for 3 weeks and developed paralysis soon. After we got a negative result of lymphomatous from a bone marrow biopsy, we took a piecemeal excision of the 10th thoracic vertebra. Titanium mesh with bone cement filling-in and mass screw internal fixation system were used for reconstructing the stability of the spine. The histopathology was consistent with NK/T-cell lymphomas.

The condition of the patient became worse suddenly after he regained some strength in his both lower limbs a week after the operation. He was not suitable for any aggressive chemotherapy or radiation therapy because of his poor condition and died 20 days later.

NK/T-cell lymphomas originated at other sites but nasal cavity/nasopharynx do not present typical clinical features and symptoms in the absence of lymphadenopathy. There are possibilities for misdiagnosis of NK/T-cell lymphoma that originates at other sites. The unfavorable prognosis of this tumor emphasized the need for novel molecular targets and more effective therapies.