Advertisement

Nasal-Type Extranodal Natural Killer/T Cell Lymphoma with Meningeal Involvement: A Case Report and Literature Review

  • Chunli Yang
  • Hongyu Zhuo
  • Liqun ZouEmail author
Short Communication
  • 3 Downloads

Abstract

Objectives

We report a case of a 26-year-old man diagnosed with nasal-type extranodal natural killer/T cell lymphoma (ENKTL) extending beyond the nasal cavity. Complete response was achieved after therapy, followed by rapid metastasis to the meningeal nerve fibres. The overall survival (OS) of the patient was 15 months. To better understand ENKTL with meningeal involvement, we summarized the clinical features of the 10 cases involving meningeal metastasis in ENKTL reported in the English literature.

Methods

The patient was admitted for the ENKTL diagnosis, and positron emission tomography-computed tomography showed the disease stage and response. When central nervous system (CNS) infiltration was suspected, magnetic resonance imaging (MRI) of the brain and spinal cord was performed, as well as cerebrospinal fluid (CSF) analysis with flow cytometric immunophenotyping.

Results

MRI of the brain and spinal cord revealed normal results. CSF analysis with flow cytometric immunophenotyping showed NK/T lymphoma cell infiltration.

Conclusion

Meningeal metastasis of ENKTL is rare; when patients present with nervous system symptoms, CNS metastasis should be considered as a possibility, even in the early stage. The OS of our patient was 15 months, which is the longest survival time reported in the literature, probably due to early diagnosis and comprehensive management, including intrathecal therapy, chemotherapy and radiotherapy of the whole brain and spinal cord.

Keywords

NK/T cell Lymphoma Metastasis Meningeal Central nervous system 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no potential conflicts of interest to report.

References

  1. 1.
    Luther N, Greenfield JP, Chadburn A, Schwartz TH (2005) Intracranial nasal natural killer/T-cell lymphoma: immunopathologically-confirmed case and review of literature. J Neurooncol 75:185–188CrossRefGoogle Scholar
  2. 2.
    Van Gorp J, De Bruin PC, Sie-Go DM et al (1995) Nasal T-cell lymphoma: a clinicopathological and immunophenotypic analysis of 13 cases. Histopathology 27:139–148CrossRefGoogle Scholar
  3. 3.
    Kim YB, Chang SK, Yang W et al (2003) Primary NK/T cell lymphoma of the testis. Acta Haematol 109:95–100CrossRefGoogle Scholar
  4. 4.
    Papalkar D, Sharma S, Francis IC et al (2009) A rapidly fatal case of T-cell lymphoma presenting as idiopathic orbital inflammation. Orbit 24:131–133CrossRefGoogle Scholar
  5. 5.
    Dunning KK, Wudhikarn K, Safo A et al (2009) Adrenal extranodal NK/T-cell lymphoma diagnosed by fine-needle aspiration and cerebrospinal fluid cytology and immunophenotyping: a case report. Diagn Cytopathol 37:686–695CrossRefGoogle Scholar
  6. 6.
    Erős N, Marschalkó M, Balassa K et al (2010) Central nervous system involvement in CD4 +/CD56 + hematodermic neoplasm: a report of two cases. J Neurooncol 97:301–304CrossRefGoogle Scholar
  7. 7.
    Hildyard C, Sheikh S, Eyre T, Collins G (2013) Extranodal NK/T cell lymphoma, nasal type, presenting with meningeal infiltration in a Caucasian female. Br J Haematol 163:550CrossRefGoogle Scholar
  8. 8.
    Cai B, Hu J, Tang Q et al (2014) Primary meningeal NK/T cell lymphoma masquerading as tuberculous meningitis. Neurol Sci 35:1467–1469CrossRefGoogle Scholar
  9. 9.
    Shimatani Y, Nakano Y, Tsuyama N et al (2016) Extranodal NK/T-cell lymphoma, nasal type, manifesting as rapidly progressive dementia without any mass or enhancing brain lesion. Neuropathology 36:456–463CrossRefGoogle Scholar
  10. 10.
    Zuhaimy H, Aziz HA, Vasudevan S, Hui HS (2017) Extranodal natural killer/T-cell lymphoma presenting as orbital cellulitis. GMS Ophthalmol Cases 7:c4Google Scholar

Copyright information

© Indian Society of Hematology and Blood Transfusion 2019

Authors and Affiliations

  1. 1.Department of Medical Oncology, Cancer Center, West China HospitalSichuan UniversityChengduChina

Personalised recommendations