喉頭節外NK/T細胞リンパ腫の診断と治療

Extranodal natural killer (NK)/T-cell lymphoma (ENKL) is an aggressive subtype of non-Hodgkin lymphoma (NHL). Its presentation in the larynx is extremely rare and may mimic tuberculosis and squamous cell carcinoma. Laryngeal ENKL is a rare form of NHL, often diagnosed at an advanced stage with a poor prognosis despite chemoradiotherapy. We report the case of a 26-year-old female patient with an eight-month history of fever, cough, hoarseness, and dysphagia. Contrast-enhanced CT revealed a mass protruding from the left posterior pharyngeal wall. Immunohistochemistry confirmed the diagnosis of laryngeal ENKL. The patient received CHOP chemotherapy (cyclophosphamide 700 mg, doxorubicin 50 mg, vincristine 2 mg, dexamethasone 20 mg), which was later changed to DeVIC (dexamethasone 40 mg, etoposide 70 mg, ifosfamide 1,000 mg, carboplatin 200 mg) with local radiotherapy. After completing treatment, the patient was readmitted four months later with multiple episodes of fever, hemoptysis, and odynophagia. Due to the inability to place a nasogastric tube, a Witzel gastrostomy was performed. However, the patient died from non-oncological causes.