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2017, Number 3

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Rev Med Inst Mex Seguro Soc 2017; 55 (3)

Extranodal NK-T-cell lymphoma, nasal type in granulomatosis with polyangiitis. A case report

Mendoza-Álvarez SA, Rodríguez-Dávila FM, Moranchel-García L, Soto V, Quispe N

Language: Spanish
References: 18
Page: 394-398
PDF size: 419.34 Kb.


ABSTRACT

Background: Granulomatosis with polyangiitis (GP) is a systemic necrotizing vasculitis with multi-organ involvement that primarily affects the respiratory tract and the kidneys. Fever in these patients is an indicator of activity; however, if it arises in isolation, the physician should exclude other causes.
Clinical case: Male patient admitted due to an unexplained fever and weight loss; it was diagnosed GP by a history of pauci-immune glomerulonephritis, fixed pulmonary nodules and chronic sinusitis of four years of evolution; however, the fever persisted despite treatment and in the absence of infection. It was performed an oropharynx lesion biopsy and the diagnosis was extranodal NK-T-cell lymphoma, nasal type, and positive for CD56 and granzyme.
Conclusion: Extranodal NK-T-cell lymphoma, nasal type is a rare entity, of poor prognosis, that should be considered as a diagnosis in patients with GP unresponsive to steroid. That is the reason why biopsy of the lesion and immunohistochemistry are required.


REFERENCES

  1. Lutalo PM, D’Cruz DP. Diagnosis and classification of granulomatosis with polyangiitis (aka Wegener’s granulomatosis). J Autoimmun. 2014 Feb-Mar;48-49:94-8.

  2. Hmidi M, Kettani M, Elboukhari A, Touiheme N, Messary A. Sinonasal NK/T-cell lymphoma. Eur Ann Otorhinolaryngol Head Neck Dis. 2013 Jun;130(3):145-7.

  3. Sokołowska-Wojdyło M, Florek A, Barańska-Rybak W, Sikorska M, Starzyńska A, Drogoszewska B, et al. Natural killer/T-cell lymphoma, nasal type, masquerading as recalcitrant periodontitis in a patient with a diagnosis of Wegener’s granulomatosis.Am J Med Sci. 2013 Feb;345(2):163-7.

  4. Trimarchi M, Sinico RA, Teggi R, Bussi M, Specks U, Meroni PL. Otorhinolaryngological manifestations in granulomatosis with polyangiitis (Wegener’s). Autoimmun Rev. 2013 Feb;12(4):501-5.

  5. Vasil’ev VI, Sedyshev SKh, Gorodetskiĭ BP, Probatova NA, Gaĭduk IV, Logvinenko OA, et al. [Differential diagnosis of Wegener’s granulomatosis and extranodal NK/T-cell lymphoma, nasal type]. [Article in Russian] Ter Arkh. 2012;84(7):79-83.

  6. Parker NP, Pearlman AN, Conley DB, Kern RC, Chandra RK. The dilemma of midline destructive lesions: a case series and diagnostic review. Am J Otolaryngol. 2010 Mar-Apr;31(2):104-9.

  7. Almouhawis HA, Leao JC, Fedele S, Porter SR. Wegener’s granulomatosis: a review of clinical features and an update in diagnosis and treatment. J Oral Pathol Med. 2013 Aug;42(7):507-16.

  8. Langford CA. Cyclophosphamide as induction therapy for Wegener’s granulomatosis and microscopic polyangiitis. Clin Exp Immunol. 2011 May;164 Suppl 1:31-4.

  9. Faurschou M, Mellemkjaer L, Voss A, Keller KK, Hansen IT, Baslund B. Prolonged risk of specific malignancies following cyclophosphamide therapy among patients with granulomatosis with polyangiitis. Rheumatology (Oxford). 2015 Aug;54(8):1345-50.

  10. Knight A, Askling J, Ekbom A. Cancer incidence in a population-based cohort of patients with Wegener’s granulomatosis. Int J Cancer. 2002 Jul 1;100(1):82-5.

  11. Nikolaos N, Grigorios P, Konstantinos K, Savvas T, Vassiliki Z, Alexandra S, et al. Extranodal nasal-type NK/T-cell lymphoma of the palate and paranasal sinuses. Am J Case Rep. 2012;13:79-85.

  12. Pamukçuoğlu M, Nasiroğlu N, Yildirim N, Ozçelik O, Oksüzoğlu B, Abali H, et al. [Sinonasal NK/T-cell lymphoma mimicking Wegener’s granulomatosis: a case report]. [Article in Turkish] Tuberk Toraks. 2006;54(3):277-80.

  13. Colburn KK, Cao JD, Krick EH, Mortensen SE, Wong LG. Hodgkin’s lymphoma in a patient treated for Wegener’s granulomatosis with cyclophosphamide and azathioprine. J Rheumatol. 1985 Jun;12(3):599-602.

  14. Sands NB, Tewfik MA, Hwang SY, Desrosiers M. Extranodal T-cell lymphoma of the sinonasal tract presenting as severe rhinitis: case series. J Otolaryngol Head Neck Surg. 2008 Aug;37(4):528-33.

  15. Dilhuydy MS, Mercié P, Viallard JF, Dumont T, Soubeyran I, Faure I, et al. [Natural killer cell nasal lymphoma mimicking localized Wegener’s disease]. [Article in French] Rev Med Interne. 2001 Jun;22(6): 571-5.

  16. Zuckerman KK, Leventhal L, Wynne C. Positive c- ANCA in a Patient with Lymphoma and Without Vasculitis. J Clin Rheumatol. 1997 Oct;3(5):279-81.

  17. Noorduyn LA, Torenbeek R, van der Valk P, Drosten PB, Snow GB, Balm AJ, et al. Sinonasal non-Hodgkin’s lymphomas and Wegener’s granulomatosis: a clinicopathological study. Virchows Arch A Pathol Anat Histopathol. 1991;418(3):235-40.

  18. Ye S, Yang CD. How could we make a diagnosis of Wegener’s granulomatosis? Clin Rheumatol. 2007 May;26(5):784-6.




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