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Intestinal NK/T cell lymphoma: A case report.
1Department of Gastroenterology, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China.
World Journal of Gastroenterology
|August 11, 2020
Summary
Intestinal Natural Killer/T cell lymphoma (NKTCL) is rare and often misdiagnosed as Crohn's disease due to atypical symptoms. Early diagnosis requires combining clinical, histological, and colonoscopic findings to improve patient outcomes.
Area of Science:
- Gastroenterology
- Oncology
- Immunology
Background:
- Intestinal Natural Killer/T cell lymphoma (NKTCL) is a rare malignancy with nonspecific symptoms.
- High misdiagnosis rates occur, often confused with Crohn's disease (CD) and other immune disorders.
- Delayed diagnosis of NKTCL leads to poor patient prognosis.
Observation:
- A patient presented with recurrent fever and colonoscopic ulcers, initially diagnosed as CD.
- Treatment with hormones and infliximab was ineffective, and the patient's condition deteriorated.
- Advanced imaging and biopsy revealed enlarged lymph nodes, positive EBV-encoded RNA, and atypical lymphocyte infiltration.
Findings:
- Immunohistochemistry confirmed CD3 positivity and Epstein-Barr virus encoded RNA expression.
- Histopathology demonstrated focal mucosal infiltration by heterotypic lymphocytes with an abnormal immune phenotype.
- The combined clinical, imaging, and pathological data led to a definitive diagnosis of NKTCL.
Implications:
- Enhanced clinician awareness of NKTCL is crucial for accurate diagnosis.
- Integrating clinical presentation, colonoscopic biopsies, and histopathological analysis can improve NKTCL detection.
- Reducing misdiagnosis of NKTCL can significantly improve patient prognosis and treatment strategies.
