Jones Daniel L, van Landingham Suzanne W, Yu John-Paul J, Lucarelli Mark J
Oculoplastic, Facial Cosmetic, and Orbital Surgery, Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin , United States.
Department of Radiology, University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin , United States.
Orbit. 2019 Oct;38(5):428-431. doi: 10.1080/01676830.2018.1546750. Epub 2018 Dec 5.
A 59-year-old Caucasian woman with past medical history significant for Natural Killer (NK)/T-cell lymphoma of the right nasal septum in remission for nine months presented after surveillance PET-CT imaging revealed increased metabolic activity in the right nasolacrimal duct. She also reported ipsilateral epiphora starting around this time. The lacrimal sac and nasolacrimal ductal mucosa were biopsied via an external approach. Pathologic evaluation revealed a proliferation of lymphoid cells with necrotic tissue. Immunohistochemical staining demonstrated predominantly CD3+, EBER+, and CD56+ cells indicating recurrent NK/T-cell lymphoma. This case describes an unusual presentation of recurrent NK/T-cell lymphoma involving the lacrimal excretory system in a Caucasian adult. Recurrent malignancy should be considered in the differential of any patient with a history of a lymphoproliferative disorder near the lacrimal drainage system who presents with new onset epiphora.
一名59岁的白种女性，既往有右鼻中隔自然杀伤（NK）/T细胞淋巴瘤病史，缓解9个月，在监测PET-CT成像显示右鼻泪管代谢活性增加后前来就诊。她还报告大约在这个时候开始出现同侧溢泪。通过外部入路对泪囊和鼻泪管黏膜进行活检。病理评估显示淋巴细胞增殖伴坏死组织。免疫组化染色显示主要为CD3 +、EBER +和CD56 +细胞，提示复发性NK/T细胞淋巴瘤。本病例描述了一名白种成年人复发性NK/T细胞淋巴瘤累及泪排泄系统的不寻常表现。对于任何有泪道引流系统附近淋巴增殖性疾病病史且出现新发溢泪的患者，鉴别诊断时应考虑复发性恶性肿瘤。
