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NK/T proliferation (2317) » B02 4607 2.jpg
Filename: B02 4607 2.jpg
[NK/T proliferation]
RETROSPECTIVE ANALYSIS:  
28yrs lady, presenting with ulcerations/destruction of oral mucosa, palate. The multiple biopsies (2001, 2002) from oral mucosa, hypopharynx, palate were taken with clinical diagnoses "Wegener granulomatosis" and "lethal midline granuloma". HISTO: on the slides (2 biopsy series). DIAGNOSIS of lymphoma WAS NOT DONE (2001, 2002).  
AUTOPSY (2002) data: The destruction and exulceration of palate durum and molle, tissues of left mandibular processus alveolaris and gingival mucosae with confluent necrosis and diffuse perivascular infiltration of atypical small- medium-large lymphocytes with irregular nuclei were present with the admixture of granulocytes, plasmacytes. Diagnosis was established (below).  
LIVER HISTOLOGY: The lymphoid infiltration in liver consisting from atypical small- medium-large lymphocytes with irregular nuclei were present. The cells were larger and pleorphism higher that in previous biopsy material.  
LUNG HISTOLOGY: The scant intraalveolar haemorhages and scant perivascular neoplastic infiltrates in the interstitium were present.  
IH (infiltrate)(RETROSPECTIVE): CD3 (cytoplasmic ε chain)/CD2/CD45RO, GranzymB/CD56 (+) C20/CD4/CD8/CD5/CD7/CD30/CD57 (-). Ki67 about 30%. EBV LMP1 (+) within single large cell CD30 cytoplasmic reaction only in liver. Immunoreactivity was significantly lower in autopsy tissues. CD16, TCR β, TCR δ immunohistochemical stains and clonality analysis were not applied (unavailable).  
PROPOSED DIAGNOSIS: NK/T extranodal lymphoma, nasal type.  
DISCUSSION:1. Differential with other CD56+ cytotox.m.+ T NHL. 2. Liver and lung infiltrates shows more pleomorphic scattered (some- EBV LMP1 and CD30+) cells, than in biopsies (EBV LMP1 (-)). DIAGNOSTIC clues in small primary biopsy.
Sender: ugnius
2006-09-06 21:02
INCTR - EBMWG Hematopathology Online

Last modified: 2006-09-06 21:02:10