Advertisement
Advertisement
Table of Contents
Definition / general | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Molecular / cytogenetics description | Molecular / cytogenetics images | Differential diagnosisCite this page: Pernick, N. NK / T cell lymphoma, nasal type. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/nasalNKlymphoma.html. Accessed December 17th, 2018.
Definition / general
- Formerly called angiocentric lymphoma, polymorphic reticulosis
- Commonly presents as lethal midline granuloma (destructive nasal or midline facial tumor)
- Common lymphoma subtype at this location in Asia (Ai Zheng 2007;26:1170, Hum Pathol 2004;35:86), Central and South America (Appl Immunohistochem Mol Morphol 2007;15:38)
- Rare in U.S.; patients are often of Asian or Hispanic descent (Am J Surg Pathol 2000;24:1511)
- Highly associated with EBV
- 5 year survival of 50% (Cancer 2006;106:609); commonly relapses to skin or subcutaneous tissue
Case reports
- 34 year old man whose postradiotherapy lymphocytes were morphologically normal but EBER1+ by ISH (Arch Pathol Lab Med 2002;126:602)
- 40 year woman with nasal sinus congestion (Case of the Week #101)
- 50 year old HIV+ African man (Arch Pathol Lab Med 2001;125:660)
Treatment
- Radiotherapy, chemotherapy
Gross description
- Usually perforated nasal septum, perforated palate, erosion of antral bone or ulceration of skin overlying nose or antrum
Microscopic (histologic) description
- Polymorphic infiltrate of lymphocytes (small to large), plasma cells, neutrophils and scattered atypical lymphoid cells with perinuclear clearing
- Frequent angiolymphatic invasion and necrosis, although vessel is usually infiltrated by atypical lymphocytes with no neutrophils and no fibrinoid necrosis present
- Often epitheliotropism
- Frequent histiocytes with erythrophagocytosis
Microscopic (histologic) images
Images hosted on PathOut server:
Case of the Week #101:
Extensive necrosis
Pleomorphic tumor cells with necrosis
Tumor cells invade vessel walls without fibrinoid necrosis
Keratin-, with positive internal control
CD20-
CD3+
CD56+
EBV+ (by ISH)
TIA+
Images hosted on other servers:
Various images
Prior to radiotherapy
Postradiotherapy cardiac involvement
Positive stains
Negative stains
Molecular / cytogenetics description
- No T cell receptor gene rearrangement, no immunoglobulin light or heavy chain rearrangements
Molecular / cytogenetics images
Images hosted on other servers:
Monoclonal proliferation of EBV+ cells
Differential diagnosis
- Diffuse large B cell lymphoma: infiltrating T cells may obscure neoplastic B cells (Am J Surg Pathol 1999;23:1356)
- Florid HSV infection: HSV+, EBV-, no angioinvasion or angiodestruction, polyclonal (Mod Pathol 2003;16:166)
- Idiopathic midline destructive disease
- Granulomatosis with polyangiitis (Wegener's)
Advertisement
