title: Primary cutaneous natural killer/T-cell lymphoma of the nasal type: a report of 4 cases in North American patients.
abstract: The "nasal" type of primary cutaneous lymphoma with natural killer/T-cell differentiation is rarely encountered outside Asia. The authors herein document 4 cases in White, North American individuals between the ages of 39 and 73 years. Their skin lesions were located on the legs in 2 cases, and they were multifocal in the other 2 patients. Microscopically, each neoplasm manifested as a dense infiltrate of cytologically aberrant lymphocytes in the dermis and subcutis. The lesional cells were angiocentric, with associated infarctive-type necrosis of the surrounding tissue. All tumors were labeled for CD3 and CD56; 3 also expressed T-cell intracellular antigen 1. Chromogenic in situ hybridization was intensely reactive for Epstein-Barr virus-encoded ribonucleic acid in each case. All patients died of their tumors or were likely to do so. The pathologic differential diagnosis of "nasal-type" natural killer/T-cell lymphoma in the skin principally centers on γ-δ T-cell lymphoma and subcutaneous panniculitis-like T-cell lymphoma. Integrated analysis of histologic, immunohistochemical, genotypic, and in situ hybridization data is necessary to separate these entities from one another.
authors.affiliation: University of Virginia School of Medicine (TP), and the Department of Pathology (MRW), University of Virginia Health System, Charlottesville, VA.
authors.forename: Travis
authors.initials: T
authors.lastname: Peck
authors.affiliation: University of Virginia School of Medicine (TP), and the Department of Pathology (MRW), University of Virginia Health System, Charlottesville, VA. Electronic address: mrwick1@usa.net.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Wick
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D004854:Herpesvirus 4, Human; D006801:Humans; D016130:Immunophenotyping; D017403:In Situ Hybridization / Q000379:methods; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D016399:Lymphoma, T-Cell / Q000473:pathology; D016410:Lymphoma, T-Cell, Cutaneous / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000378:metabolism / Q000473:pathology*; D015434:Panniculitis / Q000473:pathology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology* / Q000532:radiotherapy; D013601:T-Lymphocytes / Q000276:immunology
keywords: Cutaneous lymphoma; Epstein-Barr virus–related diseases; NK/T-cell lymphoma of “nasal” type