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Extranodal NK/T-cell Lymphoma Mimicking Erythema Multiforme
Ying Xia1, Zhen Yang1, Siyuan Chen1
1Department of Dermatology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Indian Journal of Dermatology
|June 30, 2015
Summary
Extranodal natural killer/T-cell lymphoma (ENKTL) can mimic skin conditions like erythema multiforme. This case highlights diagnostic challenges with differing biopsy results, ultimately confirming ENKTL.
Area of Science:
- Oncology
- Dermatology
- Pathology
Background:
- Extranodal natural killer/T-cell lymphoma (ENKTL) is a rare and aggressive hematologic malignancy.
- Cutaneous manifestations of ENKTL can be diverse and sometimes mimic other dermatological conditions.
- Accurate diagnosis is crucial for appropriate treatment and patient outcomes.
Purpose of the Study:
- To report a unique case of ENKTL presenting with skin lesions resembling erythema multiforme.
- To illustrate the diagnostic complexities arising from varied histopathological findings in different biopsy sites.
- To emphasize the importance of comprehensive evaluation in suspected ENKTL cases.
Main Methods:
- Case presentation of a middle-aged woman with atypical skin lesions.
- Histopathological examination and immunohistochemical analysis (CD4, CD56, CD8) of biopsies from multiple skin sites.
- Detection of Epstein-Barr virus encoded RNA (EBER) using in situ hybridization.
Main Results:
- Skin lesions clinically mimicked erythema multiforme, featuring targetoid lesions and mucosal erosions.
- Biopsy from the chest showed features consistent with CD4+ CD56+ CD8- mycosis fungoides.
- Biopsy from the scalp revealed classical ENKTL histopathology with CD56 positivity, cytotoxic proteins, and EBER.
- The patient was ultimately diagnosed with ENKTL.
Conclusions:
- ENKTL can present with clinical features that closely resemble erythema multiforme, posing a diagnostic challenge.
- Discrepant histopathological findings between biopsy sites can occur in ENKTL.
- Immunohistochemistry and molecular studies (EBER) are essential for confirming the diagnosis of ENKTL, especially in challenging cases.
