Furuya Genta, Abe Hiroyuki, Shinozaki-Ushiku Aya, Yamashita Aya, Ihara Sozaburo, Hirata Yoshihiro, Chiba Akira, Fujioka Yosei, Kurokawa Mineo, Koike Kazuhiko, Fukayama Masashi
Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Pathol Res Pract. 2018 Jul;214(7):1051-1055. doi: 10.1016/j.prp.2018.05.022. Epub 2018 May 22.
Extranodal NK/T cell lymphoma, nasal type (ENKL) developed in a patient with intestinal Epstein-Barr virus (EBV)-positive T/NK-cell lymphoproliferative disorder (LPD). The patient was a 46-year-old Chinese man who complained of diarrhea and abdominal pain without immune-deficiency. Endoscopy demonstrated ileum ulcers like Crohn's disease, without histological granulomas. His symptoms continued waxing and waning for 3 years until he developed overt lymphoma (ENKL) in the nasal cavity. The ileum lesions exacerbated into a large deep ulcer, and the biopsy specimens from the ileum, including the one 3 years ago, showed infiltration of small lymphocytes containing many EBV-positive T/NK cells without atypia. Thus, the patient illness of intestine was revealed as intestinal EBV-positive T/NK-cell LPD, which might be closely associated with development of ENKL in this patient. In cases of inflammatory bowel disease without typical clinical courses and histological findings, check-up of EBV in the biopsy might help correct diagnosis.
一名患有肠道爱泼斯坦-巴尔病毒(EBV)阳性T/NK细胞淋巴增殖性疾病(LPD)的患者发生了鼻型结外NK/T细胞淋巴瘤(ENKL)。该患者为一名46岁的中国男性,主诉腹泻和腹痛,无免疫缺陷。内镜检查显示回肠溃疡类似克罗恩病,但无组织学肉芽肿。他的症状持续波动3年,直至鼻腔出现明显的淋巴瘤(ENKL)。回肠病变恶化为一个大的深部溃疡,来自回肠的活检标本,包括3年前的标本,显示有许多含EBV阳性T/NK细胞的小淋巴细胞浸润,无异型性。因此,该患者的肠道疾病被诊断为肠道EBV阳性T/NK细胞LPD,这可能与该患者发生ENKL密切相关。对于没有典型临床病程和组织学表现的炎症性肠病病例,活检中EBV的检查可能有助于正确诊断。