Skip to main content

Advertisement

Log in

Nasal NK/T-cell lymphoma: epidemiology and pathogenesis

  • Review Article
  • Published:
International Journal of Hematology Aims and scope Submit manuscript

Abstract

Nasal NK/T-cell lymphoma (NKTCL) is an uncommon disease, but usually shows a highly aggressive clinical course. The disease is much more frequent in Asian and Latin American countries than in Western countries, and is universally associated with Epstein–Barr virus (EBV) infection. Analyses of gene mutations, especially p53 and c-KIT, revealed the different frequencies by district. Epidemiological studies revealed the changes of the disease frequency in Korea during the period from 1977–1989 to 1990–1996. Case-control study showed that the exposure to pesticides and chemical solvents could be causative of NKTCL. Further studies including HLA antigen typing of patients is necessary to further clarify the disease mechanism.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. McBride P. Photographs of a case of rapid destruction of the nose & face. Laryngol. 1987;12:64–6.

    Google Scholar 

  2. Eichel BS, Harrison EGJ, Devine KD, Scanlon PW, Brown HA. Primary lymphoma of the nose including relationship to lethal midline graanuloma. Am J Surg. 1966;112:597–605.

    Article  CAS  PubMed  Google Scholar 

  3. Kassel S, Echevaria RA, Guzzo FP. Midline malignant reticulosis (so-called lethal midline granuloma). Cancer. 1969;23:920–35.

    Google Scholar 

  4. Godman GC, Churg J. Wegener’s granulomatosis, pathology and review of the literature. Arch Pathol. 1954;58:533–53.

    CAS  Google Scholar 

  5. Ishii Y, Yamanaka N, Ogawa K, Yoshida Y, Takami T, Matsuura A, et al. Nasal T-cell lymphoma as a type of so-called “lethal midline granuloma”. Cancer. 1982;50:2336–44.

    Article  CAS  PubMed  Google Scholar 

  6. Chan KC, Ng CS, Lau WH, Lo ST. Most nasal/ nasopharyngeal lymphomas are peripheral T-cell neoplasms. Am J Surg Pathol. 1987;11:418–29.

    Article  CAS  PubMed  Google Scholar 

  7. Weiss LM, Picker LJ, Grogan TM, Warnke RA, Sklar J. Absence of clonal beta and gamma T-cell receptor gene rarrangements in a subset of peripheral T-cell lymphomas. Am J Pathol. 1988;130:436–42.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Ng CS, Chan JKC, Lo STH. Expression of natural-killer-cell markers in non-Hodgkin’s lymphomas. Hum Pathol. 1987;18:1257–62.

    Article  CAS  PubMed  Google Scholar 

  9. Aozasa K, Ohsawa M, Tomita Y, Tagawa S, Yamamura T. Polymorphic reticulosis is a neoplasm of large granular lymphocytes with CD3+ phenotype. Cancer. 1995;75:894–901.

    Article  CAS  PubMed  Google Scholar 

  10. Emile JF, Bouland ML, Maioun C, Kanavaros P, Petrella T, Delfau-Larue MH, et al. CD5 CD56+ T-cell receptor silent peripheral T-cell lymphomas are natural killer cell lymphomas. Blood. 1996;87:1466–73.

    CAS  PubMed  Google Scholar 

  11. Suzumiya J, Takeshita M, Kimura N, Kikuchi M, Uchida T, Hisano S, et al. Expression of adult and fetal natural killer cell markers in sinonasal lymphomas. Blood. 1994;83:2255–60.

    CAS  PubMed  Google Scholar 

  12. Ohsawa M, Nakatsuka S, Kanno H, Miwa H, Kojya S, Harabuchi Y, et al. Immunophenotypic and genotypic characterization of nasal lymphoma with polymorphic reticulosis morphology. Int J Cancer. 1999;81:865–70.

    Article  CAS  PubMed  Google Scholar 

  13. Jaffe ES, Harris NL, Stein H, Vardiman JW. Pathology and Genetics of Tumors of Haemapoietic and Lymphoid Tissues. Lyon, France: IARC Press, 2001.

    Google Scholar 

  14. Kluin PM, Feller A, Gaulard P, Jaffe ES, Meijer CJLM, Muller-Hermelink HK, et al. Peripheral T/NK-cell lymphoma: a report of IXth workshop of the European Association for Hematopathology. Histopathology. 2001;38:250–70.

    Article  CAS  PubMed  Google Scholar 

  15. Ng SB, Lai KW, Murugana S, Lee KM, Loong SL, Fook-Chong S, et al. Nasal type extranodal natural killer/T-cell lymphomas; A clinicopathologic and genotypic study of 42 cases in Singapore. Mod Pathol. 2004;17:1097–107.

    Article  PubMed  Google Scholar 

  16. Chan JKC, Sin VC, Wong KF, Ng CS, Tsang WY, Chan CH, et al. Nonnasal lymphomas expressing the natural killer cell marker CD56: a clinicopathologic study of 49 cases of uncommon aggressive neoplasm. Blood. 1997;89:4501–13.

    CAS  PubMed  Google Scholar 

  17. Harabuchi Y, Yamanaka N, Kataura A, Imai S, Kinoshita T, Mizuno F, et al. Epstein–Barr virus in nasal T-cell lymphomas in patients with lethal midline granuloma. Lancet. 1990;335:128–30.

    Article  CAS  PubMed  Google Scholar 

  18. Kanavaros P, Lescs MC, Briere J, Divine M, Galateau F, Joab I, et al. Nasal T-cell lymphoma: a clinicopathologic entity associated with peculiar phenotype and with Epstein–Barr virus. Blood. 1993;81:2688–95.

    CAS  PubMed  Google Scholar 

  19. Mishima K, Horiuchi K, Kojya S, Takahashi H, Ohsawa M, Aozasa K. Epstein–Barr virus in patients with polymorphic reticulosis (lethal midline granuloma) from China and Japan. Cancer. 1994;73:3041–6.

    Article  CAS  PubMed  Google Scholar 

  20. Chan JKC,Yip TTC, Tsang WYW, Ng CS, Lau WH, Poon YF, et al. Detection of Epstein–Barr viral RNA in malignant lymphomas of the upper aerodigestive tract. Am J Surg Pathol. 1994;18:938–46.

    Article  CAS  PubMed  Google Scholar 

  21. Tomita Y, Ohsawa M, Mishiro Y, Kubo T, Maeshiro S, Kojya S, et al. The presence and subtype of Epstein–Barr virus in B and T cell lymphomas of the sino-nasal region from the Osaka and Okinawa districts of Japan. Lab Invest. 1995;73:190–6.

    CAS  PubMed  Google Scholar 

  22. Tomita Y, Ohsawa M, Mishiro Y, Hashimoto M, Yang WI, Kim GE, et al. Epstein–Barr virus in lymphoproliferative diseases in the sino-nasal region: close association with CD56+ immunophenotype and polymorphic reticulosis morphology. Int J Cancer. 1997;70:9–13.

    Article  CAS  PubMed  Google Scholar 

  23. Hardjolukito E, Kurniawan AN, Kodairiah R, Ham MF, Luo WJ, Nakatsuka S, et al. Sinonasal lymphomas in Indonesia; Immunophenotype and Epstein–Barr virus association. Med J Indonesia. 2004;13:71–6.

    Article  Google Scholar 

  24. Cheung MM, Chan JK, Lau WH, Foo W, Chan PT, Ng CS, et al. Primary non-Hodgkin’s lymphoma of the nose and nasopharynx : clinical features, tumor immunophenotype, and treatment outcome in 113 patients. J Clin Oncol. 1998;16:70–7.

    Article  CAS  PubMed  Google Scholar 

  25. Dambaugh T, Hennessy K, Chamnankit L, Kieff E. U2 region of Epstein–Barr virus DNA may encode Epstein–Barr virus nuclear antigen 2. Proc Natl Acad Sci USA. 1984;81:7632–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Chen X, Pepper S, De V, Arrand JR. Prevalence of A and B types of Epstein–Barr virus DNA in nasopharyngeal carcinoma biopsies from South China. J Gen Virol. 1992;73:463–6.

    Article  CAS  PubMed  Google Scholar 

  27. Peh SC, Sardves K, Pallesen G. Epstein–Barr virus (EBV) in Malaysian upper-aerodigestive-tract lymphoma: incidence and subtype. Int J Cancer. 1995;61:327–32.

    Article  CAS  PubMed  Google Scholar 

  28. Boyle MJ, Sewell WA, Sculley TB, Apolloni A, Turner JJ, Swanson CE, et al. Subtypes of Epstein–Barr virus in human immunodeficiency virus-associated lymphohma. Blood. 1991;78:3004–11.

    CAS  PubMed  Google Scholar 

  29. Borisch B, Henning I, Laeng RH, Waelti ER, Kraft R, Laissue J. Association of the subtype 2 of the Epstein–Barr virus with T-cell non-Hodgkin’s lymphoma of the midline granuloma type. Blood. 1993;82:858–64.

    CAS  PubMed  Google Scholar 

  30. Rickinson AB, Murray RJ, Brooks J, Griffin H, Moss DJ, Masucci MG. T cell recognition of Epstein–Barr virus associated lymphomas. Cancer Surv. 1992;13:53–80.

    CAS  PubMed  Google Scholar 

  31. Shen L, Chiang AK, Liu WP, Li GD, Liang RH, Srivastava G. Expression of HLA class I, beta(2)-microglobulin, TAP 1 and IL-10 in Epstein–Barr virus-associated nasal NK/T-cell lymphoma: implications for tumor immune escape mechanism. Int J Cancer. 2001;92:692–6.

    Article  CAS  PubMed  Google Scholar 

  32. Yong L, Alfieri C, Hennessy K, Evans H, Ohara C, Anderson KC, et al. Expression of Epstein–Barr virus transformation-associated genes in tissues of patients with EBV lymphoproliferative diseases. N Engl J Med. 1989; 321:1080–5.

    Article  Google Scholar 

  33. Chiang AK, Tao Q, Srivastava G, Ho FC. Nasal NK-and T-cell lymphomas share the same type of Epstein–Barr virus latency as nasopharyngeal carcinoma and Hodgkin’s disease. Int J Cancer. 1996;68:285–90.

    Article  CAS  PubMed  Google Scholar 

  34. Chiang AK, Wong KY, Liang AC, Srivastava G. Comparative analysis of Epstein–Barr virus gene polymorphism in nasal T/NK-cell lymphomas and normal nasal tissues: implications on virus strain selection in malignancy. Int J Cancer. 1999;80:356–64.

    Article  CAS  PubMed  Google Scholar 

  35. Rickinson AB, Moss DJ. Human cytotoxic T lymphocyte responses to Epstein–Barr virus infection. Ann Rev Immunol. 1997;15:405–31.

    Article  CAS  Google Scholar 

  36. Khanna R, Burrows SR, Nicholls J, Poulsen LM. Identification of cytotoxic T cell epitopes within Epstein–Barr virus (EBV) oncogene latent membrane protein 1 (LMP1): evidence for HLA A2 subtype restricted immune recognition of EBV-infected cells by LMP1-specific cytoxic T lymphocytes. Eur J Immunol. 1998;28:451–8.

    Article  CAS  PubMed  Google Scholar 

  37. Kanno H, Kojya S, Li T, Ohsawa M, Nakatsuka S, Miyaguchi M, et al. Low frequency of HLA-A*0201 allele in patients with Epstein–Barr virus-positive nasal lymphomas with polymorphic reiculosis morphology. Int J Cancer. 2000;87:195–9.

    Article  CAS  PubMed  Google Scholar 

  38. Li T, Hongyo T, Syaifudin M, Nomura T, Dong Z, Shingu N, et al. Mutations of the p53 gene in nasal NK/T-cell lymphoma. Lab Invest. 2000;80:493–9.

    Article  CAS  PubMed  Google Scholar 

  39. Hongyo T, Li T, Syaifudin M, Baskar R, Ikeda H, Kanakura Y, et al. Specific c-kit mutations in sinonasal natural killer/T-cell lymphoma in China and Japan. Cancer Res. 2000;60:2345–7.

    CAS  PubMed  Google Scholar 

  40. Hoshida Y, Hongyo T, Jia XS, He Y, Hasui K, Dong Z, et al. Analysis of p53, k-ras, c-kit, and β-catenin gene mutatuins in sinonasal NK/T cell lymphoma in northeast district of China. Cancer Sci. 2003;94:297–301.

    Article  CAS  PubMed  Google Scholar 

  41. Hongyo T, Hoshida T, Nakatsuka S, Syaifudin M, Kojya S, Yang WI, et al. p53, k-ras, and β-catenin gene mutations in sinonasal NK/T-cell lymphoma in Korea and Japan. Oncol Rep. 2005;13:267–71.

    Google Scholar 

  42. Kurniawan AN, Hongyo T, Hardjolukito ESR, Ham MF, Takakuwa T, Kodairiah R, et al. Gene mutation analysis of sinonasal lymphoma in Indonesia. Oncol Rep. 2006;15:1257–63.

    CAS  PubMed  Google Scholar 

  43. Quintanilla-Martinez L, Kremer M, Keller G, Nathrath M, Gamboa-Dominguez A, Meneses A, et al. p53 mutations in nasal natural killer/T-cell lymphoma from Mexico: association with large ccell morphology and advanced disease. Am J Pathol. 2001;159:2095–105.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Levine AJ, Momand J, Finley CA. The p53 tumor suppressor gene. Nature. 1991;351:453–6.

    Article  CAS  PubMed  Google Scholar 

  45. Hollstein M, Sidransky D, Vogelstein B, Harris SR. p53 mutation in human cancers. Science. 1991;253:49–53.

    Article  CAS  PubMed  Google Scholar 

  46. Greenblatt MS, Benett WP, Hollstein M, Harris CC. Mutations in the p53 tumor suppressor gene: clues to cancer etiology and molecular pathogenesis. Cancer Res. 1994;54:4855–78.

    CAS  PubMed  Google Scholar 

  47. Takakuwa T, Li T, Kanno H, Nakatsuka S, Aozasa K. No evidence of replication error phenotype in nasal NK/T-cell lymphoma. Int J Cancer. 1999;84:623.

    Article  CAS  PubMed  Google Scholar 

  48. Quintanilla-Martinez L, Franklin JL, Guerrero J, Krenacs L, Naresh KN, Rama-Rao C, et al. Histological and immunophenotypic profile of nasal NK/T-cell lymphomas from Peru: higher prevalence of p53 overexpression. Hum Pathol. 1999;30:849–55.

    Article  CAS  PubMed  Google Scholar 

  49. Williams DE, de Vries P, Namen AE, Widmer MB, Lyman SD. The steel factor. Dev Biol. 1992;151:368–76.

    Article  CAS  PubMed  Google Scholar 

  50. Kitayama H, Tsujimura T, Matsumura I, Oritani K, Ikeda K, Ishikawa J, et al. Neoplastic transformation of normal hematopoietic cells by constitutively activating mutations of c-kit receptor tyrosine kinase. Blood. 1996;88:995–1004.

    CAS  PubMed  Google Scholar 

  51. Suda T, Takahashi T, Golstein P, Nagata S. Molecular cloning and expression of the Fas ligand, a novel member of the tumor necrosis factor family. Cell. 1993;75:1169–78.

    Article  CAS  PubMed  Google Scholar 

  52. Gronbaek K, Straten PT, Ralfkier E, Ahrenkiel V, Andersen MK, Hansen NE, et al. Somatic Fas mutations in non-Hodgkin’s lymphoma: association with extranodal disease and autoimmunity. Blood. 1998;92:3018–24.

    CAS  PubMed  Google Scholar 

  53. Shen L, Liang ACT, Lu L, Au WY, Kwong YL, Liang RHS, et al. Frequent delection of Fas gene sequences encoding death and transmembrane domains in nasal natural killer/T-cell lymphoma. Am J Pathol. 2002;161:2123–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Takakuwa T, Dong Z, Nakatsuka S, Kojya S, Harabuchi Y, Yang Wl, et al. Frequent mutation of Fas gene in nasal NK/T cell lymphoma. Oncogene. 2002;21:4702–5.

    Article  CAS  PubMed  Google Scholar 

  55. Sun HS, Su IJ, Lin YC, Chen JS, Fang SY. A 2.6Mb interval on chromosome 6q25.2-q25.3 is commonly deleted in human nasal natural killer/T-cell lymphoma. Br J Hematol. 2003;122:590–9.

    Article  CAS  Google Scholar 

  56. Ho FCS, Todd D, Loke SL, Ng RP, Khoo RKK. Clinicopathological features of malignant lymphomas in 294 Hong Kong Chinese patients, retrospective study covering an eight year period. Int J Cancer. 1984;34:143–8.

    Article  CAS  PubMed  Google Scholar 

  57. Chan JK, Ng CS, Lau WH, Lo STH. Most nasal/ nasopharyngeal lymphomas are peripheral T-cell lymphomas. Am J Surg Pathol. 1987;11:418–29.

    Article  CAS  PubMed  Google Scholar 

  58. Ho FC, Choy D, Loke SL, Kung ITM, Fu KH, Liang R, et al. Polymorphic reticulosis and conventional lymphomas of the nose and apper aerodigestive tract: a clinicopathologic study of 70 cases, and immunophenotypic studies of 16 cases. Hum Pathol. 1990;21:1041–50.

    Article  CAS  PubMed  Google Scholar 

  59. Aozasa K, Watanabe Y, Ikeda H. Malignant histiocytosis presenting as lethal midline granuloma. Path Res Pract. 1981;171:314–24.

    Article  CAS  PubMed  Google Scholar 

  60. Aozasa K, Inoue A. Malignant histiocytosis presenting as lethal midline graanuloma: Immunohistological study. J Pathol. 1982;138:241–9.

    Article  CAS  PubMed  Google Scholar 

  61. Aozasa K, Ohsawa M, Tajima K, Sasaki R, Maeda H, Matsunaga T, et al. Nation-wide study of lethal midline granuloma in Japan: Frequencies of Wegener’s granulomatosis, polymorphic reticulosis, malignant lymphoma and other related conditions. Int J Cancer. 1989;44:63–6.

    Article  CAS  PubMed  Google Scholar 

  62. Aozasa K, Yang WI, Lee YB, Pan WS, Wu YF, Horiuchi K, et al. Lethal midline granuloma in Seoul (Korea) and Shanghai (China). Int J Cancer. 1992;52:673–4 (Letter to the Editor).

    Article  CAS  PubMed  Google Scholar 

  63. Kojya S, Itokazu T, Maeshiro N, Esu H, Noda Y, Mishima K, et al. Lethal midline granuloma in Okinawa with special emphasis on polymorphic reticulosis. Jpn J Cancer Res. 1994;85:384–8.

    Article  CAS  PubMed  Google Scholar 

  64. Gaal K, Sun NCJ, Hernandez AM, Arber DA. Sinonasal NK/T-cell lymphomas in the United States. Am J Surg Pathol. 2000; 24:1511–7.

    Article  CAS  PubMed  Google Scholar 

  65. Rudiger T, Weisenburger DD, Anderson JR, Armitage JO, Diebold J, MacLennan KA, et al. Peripheral T-cell lymphoma (excluding anaplastic large-cell lymphoma): results from the Non-Hodgkin’s Lymphoma Classification Project. Ann Oncol. 2002;13:140–9.

    Article  CAS  PubMed  Google Scholar 

  66. Arber DA, Weiss LM, Albujor PF, Chen YY, Jaffe ES. Nasal lymphoma in Peru. High inicidencce of T-cell immunophenotype and Epstein–Barr virus infection. Am J Surg Pathol. 1993;17:392–9.

    Article  CAS  PubMed  Google Scholar 

  67. Hardjolukito E, Kurniawan AN, Kodairiah R, Ham MF, Luo WJ, Nakatsuka S, et al. Sinonasal lymphomas in Indonesia: Immunophenotype and Epstein–Barr virus association. Med J Indonesia. 2004;13:71–6.

    Article  Google Scholar 

  68. Ohsawa M, Shingu N, Inohara H, Kubo T, Yang WI, Yoon JH, et al. Chronological changes in incidences of polymorphic reticulosis in Korea and Japan. Oncol. 1999;56:202–7.

    Article  CAS  Google Scholar 

  69. Kojya S, Matsumura J, Li T, Hongvo T, Inazawa J, Kirihata M, et al. Familial nasal NK/T-cell lymphoma and icide use. Am J Hematol. 2001;66:145–7.

    Article  CAS  PubMed  Google Scholar 

  70. Zahm SH, Blair A. Pesticides and non-Hodgkin’s lymphoma. Cancer Res. 1992;52(Suppl):5485–8.

    Google Scholar 

  71. Waterhouse D, Carman WJ, Schottenfeld D, Gridley G, Mclean S. Cancer incidence in the rural community of Tecumseh, Michigan: A pattern of increased lymphopoietic neoplasms. Cancer. 1996;77:763–70.

    Article  CAS  PubMed  Google Scholar 

  72. Hardell L, Erickson MA. A case-control study of non-Hodgkin’s lymphoma and exposure to pesticide. Cancer. 1999;85:1353–60.

    Article  CAS  PubMed  Google Scholar 

  73. Xu JX, Hoshida Y, Yang WI, Inohara H, Kubo T, Kim GW, et al. Life-style and environmental factors in the development of nasal NK/T-cell lymphoma: A case-control study in East Asia. Int J Cancer. 2006;120:406–10.

    Article  Google Scholar 

  74. Miligi L, Costantini AS, Bolejack V, Varaldi A, Benvenuti A, Nanni O, et al. Non-Hodgkin’s lymphoma, leukemia, and exposure in agriculture: results from the Italian multicenter case-control study. Am J Ind Med. 2003;44:627–36.

    Article  PubMed  Google Scholar 

  75. Chiu BCH, Dave BJ, Blair A, Gapstur SM, Zahm SH, Weisenburger DD. Agricultural pesticide use and risk of t(14;18)-defined subtypes of non-Hodgkin lymphoma. Blood. 2006;108:1363–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Katsuyuki Aozasa.

Additional information

This study was supported in part by grants (1639015, 18014015) from the Ministry of Education, Culture, Sports, Science and Technology, Japan.

About this article

Cite this article

Aozasa, K., Takakuwa, T., Hongyo, T. et al. Nasal NK/T-cell lymphoma: epidemiology and pathogenesis. Int J Hematol 87, 110–117 (2008). https://doi.org/10.1007/s12185-008-0021-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12185-008-0021-7

Keywords

Navigation