Deguchi Yoshio, Yoshimatsu Kazuhiko, Endo Shungo
Digestive Disease Center, Showa University Nothern Yokohama City Hospital, 35-1 Chigasaki-chou, Yokohmama, Kanagawa, 224-8503, Japan.
Surg Today. 2006;36(5):474-7. doi: 10.1007/s00595-005-3173-6.
We report the case of a 77-year-old Japanese man with natural killer (NK)-like T cell lymphoma of the small intestine diagnosed after an emergency laparotomy for perforated peritonitis. Immunohistochemical staining of the tumor showed that the patient had CD3+ CD8+ CD30- CD56+ CD68- CD79a- UCHL-1+ EMA- LMP-1 NK-like T cell lymphoma. The patient had a history of hepatocellular carcinoma (HCC) and was also diagnosed with T cell non-Hodgkin's lymphoma associated with T cell receptor (TCR) reconstruction in the Jgamma chain. Intestinal T cell lymphoma is uncommon and very few cases of CD56+ T cell lymphoma, otherwise known as NK-like T cell lymphoma, have been reported. The patient did not have a history of gluten-sensitive enteropathy (celiac disease). Multiple lesions appeared within months after the initial operation and his condition deteriorated rapidly. We think that this patient probably had NK-type granular lymphocyte-proliferative disorder (NK-GLPD) because the percentage of CD16+ CD56+ cells among peripheral blood mononuclear cells was elevated, at 21%. We report this case to help elucidate the relationship between underlying digestive organ disease and the development of intestinal NK-like T cell lymphoma. An accumulation of other such cases is needed to determine the etiology of this disease.
我们报告了一例77岁的日本男性患者，该患者因穿孔性腹膜炎接受急诊剖腹手术后被诊断为小肠自然杀伤（NK）样T细胞淋巴瘤。肿瘤的免疫组织化学染色显示，该患者患有CD3 + CD8 + CD30 - CD56 + CD68 - CD79a - UCHL - 1 + EMA - LMP - 1 NK样T细胞淋巴瘤。该患者有肝细胞癌（HCC）病史，还被诊断为与Jγ链中T细胞受体（TCR）重排相关的T细胞非霍奇金淋巴瘤。肠道T细胞淋巴瘤并不常见，很少有CD56 + T细胞淋巴瘤（即NK样T细胞淋巴瘤）的病例报道。该患者没有麸质敏感性肠病（乳糜泻）病史。初次手术后数月内出现多处病变，病情迅速恶化。我们认为该患者可能患有NK型颗粒淋巴细胞增殖性疾病（NK - GLPD），因为外周血单个核细胞中CD16 + CD56 +细胞的百分比升高，为21%。我们报告此病例以帮助阐明潜在消化器官疾病与肠道NK样T细胞淋巴瘤发生之间的关系。需要积累更多此类病例以确定该疾病的病因。
