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CASE REPORT
Late diagnosis: a case of rapidly progressive extranodal NK/T cell lymphoma, nasal type
  1. Hiroyuki Mori1,
  2. Kei Ebisawa1,
  3. Mitsushige Nishimura2,
  4. Kenji Kanazawa3
  1. 1Department of General Internal Medicine, Kobe University Hospital, Kobe, Hyogo, Japan
  2. 2Internal Medicine, Nishiizu Kenikukai Hospital, Kamo, Shizuoka, Japan
  3. 3General Internal Medicine, Kakogawa Chuo Shimin Hospital, Kakogawa, Hyogo, Japan
  1. Correspondence to Dr Hiroyuki Mori, himori{at}med.kobe-u.ac.jp

Summary

Extranodal natural killer (NK)/T cell lymphoma, nasal type is a condition that has poor prognosis. Accurate diagnosis of lymphoma is made by pathological findings. We report a case of extranodal NK/T cell lymphoma, nasal type affecting the lung and liver and which was difficult to diagnose because of negative biopsy results from multiple sites. A 39-year-old man who had dry cough and fever for 1 month was referred to our hospital. He had pancytopenia and elevated serum levels of lactate dehydrogenase and soluble interleukin-2 receptor. Hepatosplenomegaly and multiple lung nodules were found on imaging study. Specimens of bronchoscopic lung, percutaneous liver, bone marrow and random skin biopsies were all negative. Open lung biopsy was not definitive. Unfortunately, disease progression was rapid and fatal before results of pleural fluid cytology and a second liver biopsy showed extranodal NK/T cell lymphoma, nasal type. This report focused on diagnostic planning for rapidly progressive extranodal NK/T-cell lymphoma, nasal type.

  • malignant and benign haematology
  • medical management

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Footnotes

  • Contributors All persons who meet all four ICMJE authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing, or revision of the manuscript. Furthermore, each author certifies that this material or similar material has not been and will not be submitted to or published in any other publication before its appearance in the BMJ case report. MN was involved in the acquisition of data. HM and MN were involved in the analysis and interpretation of data. HM drafted the manuscript. KE, MN and KK revised the manuscript critically for important intellectual content. All authors contributed to the conception and design of the case report, approval of the version of the manuscript to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Patient consent Parental consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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