Korean Journal of Gastrointestinal Endoscopy 2005;30(4): 204-209.
십이지장에 재발한 EBV+, CD56- 비강형 림프절 외 NK/T 세포 림프종 1예
김규종·이진혁·홍성수·변정식·양석균·김진호·민영일·허주령*
울산대학교 의과대학 서울아산병원 내과학교실, *진단병리학교실
A Case of Duodenal Relapse of Epstein-Barr Virus-positive, CD56-negative Extranodal NK/T-cell Lymphoma, Nasal Type
Kyu-Jong Kim, M.D., Gin Hyug Lee, M.D., Seong Soo Hong, M.D., Jeong-Sik Byeon, M.D., Suk-Kyun Yang, M.D., Jin-Ho Kim, M.D., Young Il Min, M.D. and Joo Ryung Huh, M.D.*
Departments of Internal Medicine and *Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Abstract
Mature T-cell and natural killer-cell neoplasms account for 10 to 15% of all non-Hodgkin's lymphomas. Of the various subtypes of mature T-cell and NK-cell lymphomas, extranodal NK/T-cell lymphoma, nasal type (nasal type NK/T-L) is relatively more common among Asians including Koreans. Nasal type NK/T-L is an aggressive, Epstein-Barr virus-associated lymphoma with characteristic expression of NK-cell antigen CD56. In this report, we present an unusual case of EBV(), CD56() NK/T-L of oropharynx which recurred in duodenum after the period of complete remission lasting for 10 years. A 58-year-old woman presented with 3 months history of abdominal pain. Gastroduodenoscopy showed the diffuse wall thickening with multiple ulcerations in bulb and proximal second portion of the duodenum. Pathological examination revealed the infiltration of atypical lymphocytes, which was positive for CD3, CD4, CD5, TIA-1, and EBV and was negative for CD15, CD20, and CD56, consistent with NK/T-L of mature T-cell origin. The past medical history included the presence of oropharyngeal mass 10 years earlier, which was diagnosed as polymorphic reticulosis. The mass resolved completely after the radiation therapy, and she remained free of the disease for 10 years. Upon review, the oropharyngeal biopsy showed an identical morphology and immunophenotype with duodenal lesion. In conclusion, we experienced an unusal case of NK/T-cell lymphoma, nasal type recured in the duodenum. (Korean J Gastrointest Endosc 2005;30:204209)
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