Hamaguchi Reo, Saito Hiroaki, Kegasawa Kyoko, Nakagawa Atsushi, Ryujin Yasushi, Kurata Kiyoko, Sugimoto Hideyasu, Kobayashi Akiko, Yamazaki Keiichi, Jin Yasuto, Yoshimura Nobuyuki
Department of Respiratory Medicine, Hiratsuka Kyosai Hospital.
Nihon Kokyuki Gakkai Zasshi. 2009 Jul;47(7):614-9.
We report a rare case of extranodal NK/T-cell lymphoma, nasal type, with skin ulceration and multiple nodules in the lung, and will compare this case with others in the literature. A 54-year-old man was troubled with flare and swelling of his right arm for one month. He was referred to our hospital because of subcutaneous nodules with ulceration on the right arm, fever, and general fatigue. Chest radiograph revealed multiple nodular shadows in both lungs. The patient was admitted for further evaluation. Chest computed tomography revealed multiple nodules in both lungs with ground-glass opacities around some of them. Some nodules seemed to be clustered in the right lower lobe. Biopsy specimens of subcutaneous nodules and transbronchial biopsy specimens of pulmonary tissue demonstrated only extensive necrosis. A VATS lung biopsy from the right S9 was then taken. Pathological and immunohistological findings suggested a diagnosis of extranodal NK/T-cell lymphoma, nasal type (WHO classification), stage IVB. The patient was transferred to the department of hematology in another hospital for systemic chemotherapy, but died 2 months later.
我们报告了一例罕见的结外NK/T细胞淋巴瘤，鼻型，伴有皮肤溃疡和肺部多发结节，并将该病例与文献中的其他病例进行比较。一名54岁男性右臂出现红肿和肿胀一个月。因右臂出现皮下结节伴溃疡、发热和全身乏力，他被转诊至我院。胸部X线片显示双肺多发结节状阴影。患者入院进一步评估。胸部计算机断层扫描显示双肺多发结节，部分结节周围有磨玻璃样混浊。一些结节似乎聚集在右下叶。皮下结节活检标本和肺组织经支气管活检标本仅显示广泛坏死。随后对右侧S9进行了电视辅助胸腔镜肺活检。病理和免疫组织学检查结果提示诊断为结外NK/T细胞淋巴瘤，鼻型（世界卫生组织分类），IVB期。患者转至另一家医院的血液科进行全身化疗，但2个月后死亡。
