CNK/T-cell brain lymphoma associated with Epstein-Barr virus in a patient with AIDS.
We report a case of extranodal NK/T-cell lymphoma, nasal type, with exclusive cerebral localization in a patient with AIDS. The patient presented with neurological alterations, fever and convulsions, so the initial presumptive diagnosis was an opportunistic brain infection. MRI showed a left parietal necrotic lesion and a stereotactic brain biopsy was performed for pathological, microbiological and molecular studies. Histological sections showed an angiocentric and angiodestructive growth pattern and the immunophenotype of this tumor was CD56+, CD45+, CD3+ (cytoplasmic), Granzyme B+ and Perforin+. All the microbiological studies such as bacterial, fungi, micobacteria, Toxoplasma gondii and Cryptococcus determination were negatives. A PCR study with primer specific for EBV viral genome of Bam-Hi-w system was positive. Also, a rearrangement study showed T-cell gene rearrangement with monoclonal appearance. A diagnosis of extranodal NK/T-cell lymphoma was made and the patient died a few days later. This case represents a very rare example of NK/T-cell lymphoma of the brain in a patient with AIDS. The diagnosis of this kind of lymphomas requires a multimodality approach correlating clinical, morphological, immunophenotypic and molecular data.
Cobo
Fernando
F
Department of Pathology and Tumor Bank, Infectious Pathology Unit, Hospital Universitario Virgen de las Nieves, Avda Fuerzas Armadas, 2,18014 Granada, Spain. fernando.cobo.sspa@juntadeandalucia.es
Talavera
Paloma
P
Busquier
Heriberto
H
Concha
Angel
A
D017088:AIDS-Related Opportunistic Infections / Q000473:pathology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001932:Brain Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology / Q000821:virology; D003937:Diagnosis, Differential; D020031:Epstein-Barr Virus Infections / Q000150:complications*; D015329:Gene Rearrangement, T-Lymphocyte; D006526:Hepatitis C / Q000150:complications; D004854:Herpesvirus 4, Human / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D007694:Killer Cells, Natural / Q000473:pathology*; D016483:Lymphoma, AIDS-Related / Q000235:genetics / Q000473:pathology* / Q000821:virology; D016399:Lymphoma, T-Cell / Q000235:genetics / Q000473:pathology* / Q000821:virology; D008279:Magnetic Resonance Imaging; D008297:Male; D016133:Polymerase Chain Reaction