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General
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Case reports
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Treatment
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- Radiotherapy, chemotherapy
Gross description
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- Usually perforated nasal septum, perforated palate, erosion of antral bone or ulceration of skin overlying nose or antrum
Micro description
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- 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
Micro images
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Extensive necrosis
Pleomorphic tumor cells with necrosis
Tumor cells invade vessel walls without fibrinoid necrosis
Keratin negative, with positive internal control
CD20 negative
CD3+
CD56+
EBV+ (by ISH)
TIA+
Various images
Prior to radiotherapy
Post-radiotherapy cardiac involvement
Positive stains
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- CD2, CD3 (cytoplasmic), EBER-ISH (100%), CD56 (65%)
- p53 (50%), CD45RO, CD43, TIA1, granzyme B, perforin (35-100%), CD8 (20%), EBV LMP1 (48%)
Negative stains
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- CD3 (nuclear), CD16 (positive on histiocytes but not tumor cells), CD57
- CD79a (usually)
Molecular description
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- No T cell receptor gene rearrangement, no immunoglobulin light or heavy chain rearrangements
Molecular images
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Monoclonal proliferation of EBV+ cells
Differential diagnosis
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End of Nasal cavity > Hematologic conditions > NK / T cell lymphoma, nasal type
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