Yang Yan-Jia, Li Ya-Xin, Liu Yan-Bin, Yang Mei, Liu Kai
Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
Oncol Lett. 2014 May;7(5):1419-1421. doi: 10.3892/ol.2014.1924. Epub 2014 Feb 28.
The current study presents a case of a 23-year-old male with CD30 nasal-type extranodal natural killer/T-cell lymphoma (NKTL), with unusual clinical features mimicking phlegmonous myositis. The patient initially presented with swelling and tenderness of the left lower limb, particularly around the left ankle. One month later, pharyngalgia and fever developed and the patient was treated with antibiotics for the phlegmonous inflammation, however, the symptoms were not relieved. A muscle biopsy was performed on the lesion and revealed diffuse infiltration of atypical lymphoid cells with irregular nuclei. Immunohistochemistry showed staining for CD3ɛ(-), CD20(-), CD45(+), CD30(+) and CD56(+) presented with positive staining for certain tumor cells, granzyme B(+), activin receptor-like kinase 1(-), Ki-67(+) and Epstein-Barr virus-encoded small RNA(+), which indicated nasal-type extranodal NKTL. The present case emphasized that extranodal NKTL may be a rare cause of phlegmonous inflammation and fever of undetermined origin.
本研究报告了一例23岁男性患有CD30鼻型结外自然杀伤/T细胞淋巴瘤(NKTL),具有类似脓性肌炎的不寻常临床特征。患者最初表现为左下肢肿胀和压痛,尤其是在左脚踝周围。一个月后,出现咽痛和发热,患者因脓性炎症接受抗生素治疗,但症状未缓解。对病变进行了肌肉活检,结果显示非典型淋巴细胞弥漫浸润,细胞核不规则。免疫组化显示CD3ɛ(-)、CD20(-)、CD45(+)、CD30(+)和CD56(+),某些肿瘤细胞呈阳性染色,颗粒酶B(+)、激活素受体样激酶1(-)、Ki-67(+)和爱泼斯坦-巴尔病毒编码的小RNA(+),提示为鼻型结外NKTL。本病例强调结外NKTL可能是脓性炎症和不明原因发热的罕见原因。