Subcutaneous panniculitis by Epstein-Barr virus-infected natural killer (NK) cell proliferation terminating in aggressive subcutaneous NK cell lymphoma.
We describe here a case involving a patient presenting initially with subcutaneous panniculitis, which developed after 12 years into aggressive subcutaneous natural killer (NK) cell lymphoma with peripheral blood involvement and hemophagocytosis. The surface marker of lymphoid cells in peripheral blood was CD2+3-7+8-16+56+. Skin biopsies were taken in May 1986 and June 1998. The initial biopsy revealed a diffuse proliferation of atypical lymphoid cells in the subcutaneous tissue with panniculitis, while the second biopsy revealed the presence of large lymphoid cells in the subcutaneous tissue with necrotic changes, consistent with a diagnosis of malignant lymphoma (diffuse pleomorphic type). The lymphoid cells from these two specimens were positive for CD56 and such cytotoxic molecules as T-cell intracellular antigen-1 (TIA-1), granzyme B, and, interestingly, also positive for Epstein-Barr (EB) virus by in situ hybridization. This suggests that chronic EB virus infections play an important role in the early stages of tumorigenesis and in the progression of NK cell lymphoproliferative disorders.
Abe
Y
Y
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. abey@intmed3.med.kyushu-u.ac.jp
Muta
K
K
Ohshima
K
K
Yasumoto
S
S
Shiratsuchi
M
M
Saito
R
R
Tsujita
J
J
Shibata
T
T
Furue
M
M
Kikuchi
M
M
Nishimura
J
J
Nawata
H
H
D048868:Adaptor Proteins, Signal Transducing; D000328:Adult; D001706:Biopsy; D015139:Blotting, Southern; D002352:Carrier Proteins; D002455:Cell Division; D003598:Cytoskeletal Proteins; D020031:Epstein-Barr Virus Infections; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D047908:Intracellular Signaling Peptides and Proteins; D007694:Killer Cells, Natural / Q000473:pathology / Q000821:virology*; D060588:LIM Domain Proteins; D016410:Lymphoma, T-Cell, Cutaneous / Q000209:etiology*; D015434:Panniculitis / Q000821:virology*; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000209:etiology*; D013194:Staining and Labeling; D016335:Zinc Fingers
D048868:Adaptor Proteins, Signal Transducing; D002352:Carrier Proteins; D003598:Cytoskeletal Proteins; D047908:Intracellular Signaling Peptides and Proteins; D060588:LIM Domain Proteins; C484380:PDLIM7 protein, human