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[Nasal NK-cell lymphoma]

J Fukuda1, T Yoshihara, Y Arai

  • 1Department of Hematology, Tokyo Women's Medical College.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|June 1, 1994
PubMed
Summary

This study identifies a rare nasal lymphoma in a patient, revealing it originated from activated Natural Killer (NK) cells infected by the Epstein-Barr virus (EBV). This finding may explain chemotherapy resistance in nasal lymphomas.

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Area of Science:

  • Oncology
  • Immunology
  • Virology

Background:

  • Nasal lymphomas are rare and often present with non-specific symptoms.
  • Diagnosis typically involves biopsy and immunophenotyping.

Observation:

  • A 75-year-old male presented with nasal obstruction, epistaxis, fever, night sweats, and weight loss.
  • A nasal biopsy revealed a diffuse, mixed-type non-Hodgkin's lymphoma with cytoplasmic azurophilic granules.
  • Tumor cells exhibited specific CD markers (CD2+, CD7+, CD16+, CD56+) and lacked T cell receptor gene rearrangement.

Findings:

  • The tumor cells demonstrated strong Natural Killer (NK) cell activity.
  • Immunophenotypic and cytotoxic analyses suggested derivation from activated NK cells.
  • Epstein-Barr virus (EBV) positivity and CD21 antigen expression indicated EBV-infected NK cell transformation.

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  • Multidrug resistance P-glycoprotein was also detected in tumor cells.
  • Implications:

    • This case suggests a potential origin of nasal lymphoma from EBV-infected, activated NK cells.
    • The presence of MDR P-glycoprotein may contribute to the observed chemotherapy resistance and poor prognosis in nasal lymphomas.
    • Understanding the cellular origin and molecular mechanisms is crucial for developing targeted therapies.