Journal of Hematopathology

, Volume 12, Issue 4, pp 207–211 | Cite as

Primary pulmonary extranodal NK/T cell lymphoma of an elderly adult: a case report and literature review

  • Chenhong Zhang
  • Zhiwei Lu
  • Xuefei Bai
  • Yinhua Liu
  • Shanhao Liu
  • Wang Wang
  • Yifeng Jin
  • He Zhang
  • Hesheng HeEmail author
Case Report


Extranodal natural killer/T-cell lymphoma (ENKTCL), nasal type, is rare and aggressive and often involves the nose, nasopharynx, and upper aerodigestive tract. The non-nasal type can affect the skin, salivary glands, gut, testes, brain, salivary glands, and other sites. Primary ENKTCL of the lung is rare. Here, we report a 68-year-old non-smoking female who presented with fever, dry cough, and night sweats. The chest image showed lung consolidation in the right lower lung field. Pulmonary biopsy showed diffuse abnormal lymphocyte infiltrate in the necrotic exudate. Immunohistochemical data indicated that the tumour cells were positive for CD56, granzyme B, CD3, and TIA. Using in situ hybridization, Epstein–Barr virus-encoded ribonucleic acid (EBER) was detected. There was no evidence to indicate extrathoracic lymphoma involvement. Primary pulmonary ENKTCL was therefore diagnosed. The patient underwent chemotherapy using the P-GEMOX regimen (pegaspargase, gemcitabine, and oxaliplatin) and is still alive.


Extranodal NK/T-cell lymphoma Epstein–Barr virus Lung cancer Lymphoma P-GEMOX 


Funding information

We are supported by the University Natural Science Key Project of Anhui Province (KJ2018A0269).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent

Informed consent was obtained from all participants included in the study.


  1. 1.
    Kwong YL, Kim WS, Lim ST, Kim SJ, Tang T, Tse E, Leung AY, Chim CS (2012) SMILE for natural killer/T-cell lymphoma: analysis of safety and efficacy from the Asia lymphoma study group. Blood 120:2973–2980. CrossRefPubMedGoogle Scholar
  2. 2.
    Tse E, Kwong YL (2013) How I treat NK/T-cell lymphomas. Blood 121:4997–5005. CrossRefPubMedGoogle Scholar
  3. 3.
    Lee S, Shin B, Yoon H, Lee JY, Chon GR (2016) A case of primary pulmonary NK/T cell lymphoma presenting as pneumonia. Respir Med Case Rep 17:1–4. CrossRefPubMedGoogle Scholar
  4. 4.
    Zhou P, Fan S, Dai Y, Tang F, Zhang H (2017) Case report primary pulmonary NK/T cell lymphoma: report of a rare entity and review of literature. Int J Clin Exp Pathol 10:3570–3576Google Scholar
  5. 5.
    Lee BH, Kim SY, Kim MY, Hwang YJ, Han YH, Seo JW, Kim YH, Cha SJ, Hur G (2006) CT of nasal-type T/NK cell lymphoma in the lung. J Thorac Imaging 21:37–39. CrossRefPubMedGoogle Scholar
  6. 6.
    Gong L, Wei LX, Huang GS, Zhang WD, Wang L, Zhu SJ, Han XJ, Yao L, Lan M, Li YH, Zhang W (2013) Identification of genuine primary pulmonary NK cell lymphoma via clinicopathologic observation and clonality assay. Diagn Pathol 8:140–147. CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Laohaburanakit P, Hardin KA (2006) NK/T cell lymphoma of the lung: a case report and review of literature. Thorax 61:267–270. CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Chien CC, Lee HS, Lin MH, Hsieh PP (2016) Primary extranodal natural killer/T-cell lymphoma of bronchus and lung: a case report and review of literature. Thorac Cancer 7:140–144. CrossRefPubMedGoogle Scholar
  9. 9.
    Liu CH, Wang HH, Perng CL, Peng CK, Chian CF, Shen CH (2014) Primary extranodal NK/T-cell lymphoma of the lung: mimicking bronchogenic carcinoma. Thorac Cancer 5:93–96. CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Song M, Kim JY, Choi JS, Yoon B, Kim M, Kim SJ, Kim SY (2017) Primary pulmonary extranodal natural killer/T-cell lymphoma, nasal type presenting as diffuse ground glass opacities: a case report. J Korean Med Sci 32:1727–1730. CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Oshima K, Tanino Y, Sato S, Inokoshi Y, Saito J, Ishida T, Fukuda T, Watanabe K, Munakata M (2012) Primary pulmonary extranodal natural killer/T-cell lymphoma: nasal type with multiple nodules. Eur Respir J 40:795–798. CrossRefPubMedGoogle Scholar
  12. 12.
    Zhang J, Wang M, Yang X, Liu C, He X (2017) Primary pulmonary extranodal NK/T-cell lymphoma of nasal type misdiagnosed as pneumonia: a case report and literature review. Medicine (Baltimore) 96:e8914. CrossRefGoogle Scholar
  13. 13.
    Qiu Y, Hou J, Hao D, Zhang D (2018) Primary pulmonary NK/T-cell lymphoma: a case report and literature review. Mol Clin Oncol 8:753–756. CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Gui W, Yang B, Shen Q, Bai M, Wang J, Guan T, Zhao J, Wang J, Su L (2015) Successful treatment with L-asparaginase-based regimen for primary pulmonary NK/T cell lymphoma: a case report and review of the literature. Clin Respir J 9:493–496. CrossRefPubMedGoogle Scholar
  15. 15.
    Davis BW, Beasley MB, Dua S (2010) Primary pulmonary natural killer/T-Cell lymphoma presenting as nonresolving pneumonia. Chest 138:18A. CrossRefGoogle Scholar
  16. 16.
    National Comprehensive Cancer Network (2016) NCCN clinical practice guidelines in oncology. The National Comprehensive Cancer Network (NCCN), Plymouth Meeting, PAGoogle Scholar
  17. 17.
    van Dongen JJ, Langerak AW, Bruggemann M et al (2003) Design and standardization of PCR primers and protocols for detection of clonal immunoglobulin and T-cell receptor gene recombinations in suspect lymphoproliferations: report of the BIOMED-2 concerted action BMH4-CT98-3936. Leukemia 17:2257–2317. CrossRefPubMedGoogle Scholar
  18. 18.
    Devins K, Schuster SJ, Caponetti GC, Bogusz AM (2018) Rare case of low-grade extranodal NK/T-cell lymphoma, nasal type, arising in the setting of chronic rhinosinusitis and harboring a novel N-terminal KIT mutation. Diagn Pathol 13:92–97. CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Tse E, Kwong YL (2017) The diagnosis and management of NK/T-cell lymphomas. J Hematol Oncol 10:85. CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Respirationthe Affiliated Yijishan Hospital of Wannan Medical CollegeWuhuChina
  2. 2.Department of Pathologythe Affiliated Yijishan Hospital of Wannan Medical CollegeWuhuChina
  3. 3.Department of Hematologythe Affiliated Yijishan Hospital of Wannan Medical CollegeWuhuChina

Personalised recommendations