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Extranodal NK/T-cell lymphoma mimicking Crohn's colitis.
W S Wan Ahmad Kammal1, I Mohd Rose, R R Md Zin
1Universiti Kebangsaan Malaysia (UKM) Medical Centre, Faculty of Medicine, Department of Pathology, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 36000 Kuala Lumpur, Malaysia. noraidah@ppukm.ukm.edu.my.
Extranodal NK/T cell lymphoma is a rare gastrointestinal cancer. This case highlights its potential to mimic Crohn's disease, emphasizing the need for thorough histopathology for accurate diagnosis.
Area of Science:
- Oncology
- Gastroenterology
- Pathology
Background:
- Extranodal NK/T cell lymphoma (ENKTL) is a rare malignancy.
- Primary ENKTL of the colon is exceptionally rare.
- Typically affects the upper aerodigestive tract, skin, testes, or soft tissues.
Observation:
- A 46-year-old male presented with abdominal pain, weight loss, and rectal bleeding.
- Colonoscopy revealed aphthous ulcers mimicking Crohn's colitis.
- CT scan showed circumferential colonic thickening.
Findings:
- Histopathology revealed malignant lymphoid cells with necrosis, angiocentricity, and angiodestruction.
- Immunohistochemistry confirmed T-cell monoclonality, cytotoxic granules, and Epstein-Barr virus (EBV) infection.
- Diagnosis: Extranodal NK/T cell lymphoma of the colon.
Implications:
- Colonic ENKTL can clinically mimic benign inflammatory conditions like Crohn's disease.
- Accurate diagnosis relies on comprehensive histological and immunohistochemical analysis.
- Highlights the importance of considering rare differentials in gastrointestinal pathology.
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