MDT discussion of a case of primary intestinal extranodal nasal type NK/T-cell lymphoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DONG Baolong ^1,2 , DONG Xiaohua ¹ , ZHAO Huiqi ¹ , WANG Caiying ² ,  YANG Xiaojun ¹

1. The 2^st Department of General Surgery, Gansu Provincial Hospital, Lanzhou 730000, P. R. China;
2. Clinical College of Gansu University of Chinese Medicine, Lanzhou 730000, P. R. China;

Corresponding author：

YANG Xiaojun, Email: yangxjmd@aliyun.com

Keywords：

primary intestinal extranodal nasal type NK/T-cell lymphoma; MDT; rare disease

DOI：

10.7507/1007-9424.201905105

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the diagnosis and clinicopathological features of primary intestinal extranodal nasal type NK/T-cell lymphoma (PI-ENKTCL), and to enhance the diagnostic and differential diagnosis of this rare disease.Methods The clinicopathologic data of a patient with PI-ENKTCL admitted to Gansu Provincial Hospital in January 2019 were retrospectively analyzed.Results We diagnosed PI-ENKTCL doubtfully by PET-CT , and after the discussion of MDT, we finished radical operation which achieved R0 resection. The pathological type was consistent with PI-ENKTCL diagnosis. The operation lasted 280 minutes, and the intraoperative blood loss was about 50 mL. Postoperative pathology confirmed that the tumor margin was negative and no postoperative complication occurred, and the patient was discharged successfully on the 13^th day after the operation. The patient, followed for five months after operation, was treated with L-GMOEX [gemcitabine+oxaliplatin combined with L-asparaginase (L-ASP)] chemotherapy for four periods at time, and the treatment effect continued to be followed up.Conclusions It is necessary to discuss by MDT for doubtfully diagnosing PI-ENKTCL because of the disease being rare. The imaging diagnosis is mainly PET-CT. Surgical resection is the main treatment, we should formulate the best chemotherapy according to post-operation pathological results, for improving the patient’s prognosis and prolonging patient’s life with PI-ENKTCL.

Citation： DONG Baolong, DONG Xiaohua, ZHAO Huiqi, WANG Caiying, YANG Xiaojun. MDT discussion of a case of primary intestinal extranodal nasal type NK/T-cell lymphoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(12): 1461-1466. doi: 10.7507/1007-9424.201905105 Copy

1.	Suzuki R. Pathogenesis and treatment of extranodal natural killer/T-cell lymphoma. Semin Hematol, 2014, 51(1): 42-51.
2.	Jhuang JY, Chang ST, Weng SF, et al. Extranodal natural killer/T-cell lymphoma, nasal type in Taiwan: a relatively higher frequency of T-cell lineage and poor survival for extranasal tumors. Hum Pathol, 2015, 46(2): 313-321.
3.	Li S, Feng X, Li T, et al. Extranodal NK/T-cell lymphoma, nasal type: a report of 73 cases at MD Anderson Cancer Center. Am J Surg Pathol, 2013, 37(1): 14-23.
4.	Takata K, Hong ME, Sitthinamsuwan P, et al. Primary cutaneous NK/T-cell lymphoma, nasal type and CD56-positive peri-pheral T-cell lymphoma: a cellular lineage and clinicopathologic study of 60 patients from Asia. Am J Surg Pathol, 2015, 39(1): 1-12.
5.	Aozasa K, Zaki MA. Epidemiology and pathogenesis of nasal NK/T-cell lymphoma: a mini-review. ScientificWorldJournal, 2011, 11(11): 422-428.
6.	Suzuki R, Suzumiya J, Yamaguchi M, et al. Prognostic factors for mature natural killer (NK) cell neoplasms: aggressive NK cell leukemia and extranodal NK cell lymphoma, nasal type. Ann Oncol, 2010, 21(5): 1032-1040.
7.	Yamaguchi M, Kwong YL, Kim WS, et al. Phase Ⅱ study of SMILE chemotherapy for newly diagnosed stage Ⅳ, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol, 2011, 29(33): 4410-4416.
8.	Yong W. Clinical study of l-asparaginase in the treatment of extranodal NK/T-cell lymphoma, nasal type. Hematol Oncol, 2016, 34(2): 61-68.
9.	Fang JC, Xia ZX, Wang CN, et al. Clinicopathologic and immunophenotypic features of primary intestinal extranodal NK/T-cell lymphoma, nasal type. Int J Surg Pathol, 2015, 23(8): 609-616.
10.	Jiang M, Chen X, Yi Z, et al. Prognostic characteristics of gastrointestinal tract NK/T-cell lymphoma: an analysis of 47 patients in China. J Clin Gastroenterol, 2013, 47(8): e74-e79.
11.	Kim SJ, Jung HA, Chuang SS, et al. Extranodal natural killer/T-cell lymphoma involving the gastrointestinal tract: analysis of clinical features and outcomes from the Asia Lymphoma Study Group. J Hematol Oncol, 2013, 6(1): 86.
12.	Sun J, Lu Z, Yang D, et al. Primary intestinal T-cell and NK-cell lymphomas: a clinicopathological and molecular study from China focused on type Ⅱ enteropathy-associated T-cell lymphoma and primary intestinal NK-cell lymphoma. Mod Pathol, 2011, 24(7): 983-992.
13.	Chuang SS, Chang ST, Chuang WY, et al. NK-cell lineage predicts poor survival in primary intestinal NK-cell and T-cell lymphomas. Am J Surg Pathol, 2009, 33(8): 1230-1240.
14.	Wan M, Chow J, Lei K, et al. Allelotyping of gastrointestinal nasal-type NK/T-cell lymphoma. Leuk Res, 2004, 28(4): 339-343.
15.	Avilés A, Díaz NR, Neri N, et al. Angiocentric nasal T/natural killer cell lymphoma: a single centre study of prognostic factors in 108 patients. Clin Lab Haematol, 2000, 22(4): 215-220.
16.	肖阳, 王梅, 刘洁婷, 等. 胃淋巴瘤肝转移 1 例报道. 中国普外基础与临床杂志, 2014, 21(6): 787.
17.	Chan WK, Au WY, Wong CY, et al. Metabolic activity measured by F-18 FDG PET in natural killer-cell lymphoma compared to aggressive B- and T-cell lymphomas. Clin Nucl Med, 2010, 35(8): 571-575.
18.	金圣杰, 柏斗胜. 多系统结节病 (18)F-脱氧葡萄糖 PET 显像误诊为淋巴瘤 1 例报道. 中国普外基础与临床杂志, 2015, 22(2): 256.
19.	Pongpruttipan T, Sukpanichnant S, Assanasen T, et al. Extranodal NK/T-cell lymphoma, nasal type, includes cases of natural killer cell and αβ, γδ, and αβ/γδ T-cell origin: a comprehensive clinicopathologic and phenotypic study. Am J Surg Pathol, 2012, 36(4): 481-499.
20.	Li X, Babayi A, Sang W, et al. Clinicopathologic, immunophenotypic, and EBER in situ hybridization study of extranodal natural killer/T-cell lymphoma, nasal type in ãmulti-ethnic groups. Clin Lab, 2014, 60(3): 419-425.
21.	Kim SJ, Kim BS, Choi CW, et al. Ki-67 expression is predictive of prognosis in patients with stage Ⅰ/Ⅱ extranodal NK/T-cell lymphoma, nasal type. Ann Oncol, 2007, 18(8): 1382-1387.
22.	Wang GB, Xu GL, Luo GY, et al. Primary intestinal non-Hodgkin’s lymphoma: a clinicopathologic analysis of 81 patients. World J Gastroenterol, 2011, 17(41): 4625-4631.
23.	Yamaguchi M, Kita K, Miwa H, et al. Frequent expression ofP-glycoprotein/MDR1 by nasal T-cell lymphoma cells. Cancer, 1995, 76(11): 2351-2356.
24.	Tse E, Kwong YL. The diagnosis and management of NK/T-cell lymphomas. J Hematol Oncol, 2017, 10(1): 85.
25.	Chen BJ, Chapuy B, Ouyang J, et al. PD-L1 expression is characteristic of a subset of aggressive B-cell lymphomas and virus-associated malignancies. Clin Cancer Res, 2013, 19(13): 3462-3473.
26.	Jo JC, Kim M, Choi Y, et al. Expression of programmed cell death 1 and programmed cell death ligand 1 in extranodal NK/T-cell lymphoma, nasal type. Ann Hematol, 2016, 96(1): 1-7.

1. Suzuki R. Pathogenesis and treatment of extranodal natural killer/T-cell lymphoma. Semin Hematol, 2014, 51(1): 42-51.
2. Jhuang JY, Chang ST, Weng SF, et al. Extranodal natural killer/T-cell lymphoma, nasal type in Taiwan: a relatively higher frequency of T-cell lineage and poor survival for extranasal tumors. Hum Pathol, 2015, 46(2): 313-321.
3. Li S, Feng X, Li T, et al. Extranodal NK/T-cell lymphoma, nasal type: a report of 73 cases at MD Anderson Cancer Center. Am J Surg Pathol, 2013, 37(1): 14-23.
4. Takata K, Hong ME, Sitthinamsuwan P, et al. Primary cutaneous NK/T-cell lymphoma, nasal type and CD56-positive peri-pheral T-cell lymphoma: a cellular lineage and clinicopathologic study of 60 patients from Asia. Am J Surg Pathol, 2015, 39(1): 1-12.
5. Aozasa K, Zaki MA. Epidemiology and pathogenesis of nasal NK/T-cell lymphoma: a mini-review. ScientificWorldJournal, 2011, 11(11): 422-428.
6. Suzuki R, Suzumiya J, Yamaguchi M, et al. Prognostic factors for mature natural killer (NK) cell neoplasms: aggressive NK cell leukemia and extranodal NK cell lymphoma, nasal type. Ann Oncol, 2010, 21(5): 1032-1040.
7. Yamaguchi M, Kwong YL, Kim WS, et al. Phase Ⅱ study of SMILE chemotherapy for newly diagnosed stage Ⅳ, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol, 2011, 29(33): 4410-4416.
8. Yong W. Clinical study of l-asparaginase in the treatment of extranodal NK/T-cell lymphoma, nasal type. Hematol Oncol, 2016, 34(2): 61-68.
9. Fang JC, Xia ZX, Wang CN, et al. Clinicopathologic and immunophenotypic features of primary intestinal extranodal NK/T-cell lymphoma, nasal type. Int J Surg Pathol, 2015, 23(8): 609-616.
10. Jiang M, Chen X, Yi Z, et al. Prognostic characteristics of gastrointestinal tract NK/T-cell lymphoma: an analysis of 47 patients in China. J Clin Gastroenterol, 2013, 47(8): e74-e79.
11. Kim SJ, Jung HA, Chuang SS, et al. Extranodal natural killer/T-cell lymphoma involving the gastrointestinal tract: analysis of clinical features and outcomes from the Asia Lymphoma Study Group. J Hematol Oncol, 2013, 6(1): 86.
12. Sun J, Lu Z, Yang D, et al. Primary intestinal T-cell and NK-cell lymphomas: a clinicopathological and molecular study from China focused on type Ⅱ enteropathy-associated T-cell lymphoma and primary intestinal NK-cell lymphoma. Mod Pathol, 2011, 24(7): 983-992.
13. Chuang SS, Chang ST, Chuang WY, et al. NK-cell lineage predicts poor survival in primary intestinal NK-cell and T-cell lymphomas. Am J Surg Pathol, 2009, 33(8): 1230-1240.
14. Wan M, Chow J, Lei K, et al. Allelotyping of gastrointestinal nasal-type NK/T-cell lymphoma. Leuk Res, 2004, 28(4): 339-343.
15. Avilés A, Díaz NR, Neri N, et al. Angiocentric nasal T/natural killer cell lymphoma: a single centre study of prognostic factors in 108 patients. Clin Lab Haematol, 2000, 22(4): 215-220.
16. 肖阳, 王梅, 刘洁婷, 等. 胃淋巴瘤肝转移 1 例报道. 中国普外基础与临床杂志, 2014, 21(6): 787.
17. Chan WK, Au WY, Wong CY, et al. Metabolic activity measured by F-18 FDG PET in natural killer-cell lymphoma compared to aggressive B- and T-cell lymphomas. Clin Nucl Med, 2010, 35(8): 571-575.
18. 金圣杰, 柏斗胜. 多系统结节病 (18)F-脱氧葡萄糖 PET 显像误诊为淋巴瘤 1 例报道. 中国普外基础与临床杂志, 2015, 22(2): 256.
19. Pongpruttipan T, Sukpanichnant S, Assanasen T, et al. Extranodal NK/T-cell lymphoma, nasal type, includes cases of natural killer cell and αβ, γδ, and αβ/γδ T-cell origin: a comprehensive clinicopathologic and phenotypic study. Am J Surg Pathol, 2012, 36(4): 481-499.
20. Li X, Babayi A, Sang W, et al. Clinicopathologic, immunophenotypic, and EBER in situ hybridization study of extranodal natural killer/T-cell lymphoma, nasal type in ãmulti-ethnic groups. Clin Lab, 2014, 60(3): 419-425.
21. Kim SJ, Kim BS, Choi CW, et al. Ki-67 expression is predictive of prognosis in patients with stage Ⅰ/Ⅱ extranodal NK/T-cell lymphoma, nasal type. Ann Oncol, 2007, 18(8): 1382-1387.
22. Wang GB, Xu GL, Luo GY, et al. Primary intestinal non-Hodgkin’s lymphoma: a clinicopathologic analysis of 81 patients. World J Gastroenterol, 2011, 17(41): 4625-4631.
23. Yamaguchi M, Kita K, Miwa H, et al. Frequent expression ofP-glycoprotein/MDR1 by nasal T-cell lymphoma cells. Cancer, 1995, 76(11): 2351-2356.
24. Tse E, Kwong YL. The diagnosis and management of NK/T-cell lymphomas. J Hematol Oncol, 2017, 10(1): 85.
25. Chen BJ, Chapuy B, Ouyang J, et al. PD-L1 expression is characteristic of a subset of aggressive B-cell lymphomas and virus-associated malignancies. Clin Cancer Res, 2013, 19(13): 3462-3473.
26. Jo JC, Kim M, Choi Y, et al. Expression of programmed cell death 1 and programmed cell death ligand 1 in extranodal NK/T-cell lymphoma, nasal type. Ann Hematol, 2016, 96(1): 1-7.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

MDT discussion of a case of primary intestinal extranodal nasal type NK/T-cell lymphoma

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content