Nasal-type extranodal natural killer/T-cell lymphoma presenting with extensive leg ulcers.
Primary cutaneous T-cell lymphomas are rare and can be difficult to classify precisely. We present a case of extranodal natural killer (NK)/T-cell lymphoma in a previously healthy, immunocompetent man who presented with extensive necrotic leg ulcers and disseminated skin nodules. Immunohistochemical studies revealed that the tumour cells were positive for CD3, CD30, granzyme B and T-cell intracellular antigen-1, and negative for CD5 and CD56, with positive staining for Epstein-Barr virus (EBV) RNA on in situ hybridization. A diagnosis of extranodal NK/T-cell lymphoma was made, based on the presence of cytotoxic granules and positive EBV RNA staining. The patient was treated with a regimen of chemotherapy comprising corticosteroids, intravenous methotrexate, ifosphamide, L-asparaginase and etoposide with initial response.
Chia
H Y
HY
Department of Dermatology, National Skin Centre, Singapore. hychia@nsc.gov.sg
Tey
H L
HL
Tan
K B
KB
Chong
W S
WS
D014408:Biomarkers, Tumor / Q000032:analysis; D019002:CD56 Antigen / Q000032:analysis; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D017730:Ki-1 Antigen / Q000032:analysis; D007871:Leg Ulcer / Q000188:drug therapy / Q000473:pathology*; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology*
D014408:Biomarkers, Tumor; D019002:CD56 Antigen; D017730:Ki-1 Antigen