Accurate Diagnose and management of advanced nasal type extranodal NK/T cell lymphoma. A case Report.

• Main Authors: Luis Felipe Romero Moreno, Liliana Ramos-Valencia, Juan Sebastián Parra-Charris, Ricardo Ángel-Obando
• Format: Article
• Language: English
• Published: Universidad Nacional de Colombia 2017-01-01
• Series: Case Reports
• Subjects: NK/T cell lymphoma; Antineoplasic Protocols; Radiotherapy; Granuloma, Lethal Midline
• Online Access: https://revistas.unal.edu.co/index.php/care/article/view/60912

Extranodal natural killer (NK)/T-cell lymphoma, nasal type, is a rare entity in otorhinolaryngology. Its management requires skilled physicians in order to suspect this disease and making a proper diagnosis at early stages. This paper reports the case of a 31-year-old male patient, with one month of nasal obstruction, recurrent sinusitis, palatal ulceration and a necrotizing lesion. Histopathology reported lymphoid infiltrate polymorph angiocentric growth pattern and extensive areas of necrosis. Immunohistochemistry confirmed the phenotype for T/NK cells: positive CD3, BCL2, CD4 and CD56. IgG for Epstein-Barr virus was also positive. The initial staging was T4, N1, M0,  Eastern Cooperative Oncology Group (ECOG) scale was 1, with intermediate risk, and low  International Prognostic Index (IPI); based on this results, the patient was referred to oncology to initiate treatment. After a ten-month follow-up, the patient’s condition improved, with complete remission of nasal and palate injuries; no relapse has occurred to date. This case is a clear example of the importance of early diagnostic through multiple biopsies in order to establish a specific treatment to decrease complication rates and improve prognosis.