误诊为多发性肌炎的结外自然杀伤/T细胞淋巴瘤的肌肉受累：一例报告并文献复习
Muscular involvement of extranodal natural killer/T cell lymphoma misdiagnosed as polymyositis: A case report and review of literature.
作者信息
Liu Li-Hui, Huang Qing, Liu Yun-Hai, Yang Jie, Fu Han, Jin Lin
机构信息
Department of Neurology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China.
Department of Dermatology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China.
出版信息
World J Clin Cases. 2020 Mar 6;8(5):963-970. doi: 10.12998/wjcc.v8.i5.963.
BACKGROUND
Natural killer (NK)/T cell lymphoma is a rare and highly aggressive malignant tumor, and is a special form of non-Hodgkin's lymphoma. Although extranodal involvement is frequently found in tissues such as the skin, testicular and gastrointestinal tract , its presence in skeletal muscle has scarcely been reported in the literature.
CASE SUMMARY
We report a case of extranodal NK/T cell lymphoma with muscle swelling as the first clinical manifestation. A 42-year-old man, who initially presented with localized swelling in the double lower extremities, demonstrated gradual facial and eyelid swelling, and his imaging results showed multiple sites of muscle damage throughout the body. The final pathological results suggested NK/T cell lymphoma, and immunohistochemistry showed CD20 (-), CD3Ɛ (+), CD30 (+), CD56 (-), EBER (+), Ki67 (60%), TIA-1 (+) and CD68 (±) staining. The muscle swelling significantly improved after treatment with chemotherapy regimens.
CONCLUSION
This disease is difficult to diagnose and highly invasive, and should be included in the differential diagnosis of unexplained muscle swelling.
背景
自然杀伤（NK）/T细胞淋巴瘤是一种罕见且侵袭性很强的恶性肿瘤，是非霍奇金淋巴瘤的一种特殊形式。尽管结外受累常见于皮肤、睾丸和胃肠道等组织，但其在骨骼肌中的存在在文献中鲜有报道。
病例摘要
我们报告一例以肌肉肿胀为首发临床表现的结外NK/T细胞淋巴瘤病例。一名42岁男性，最初表现为双下肢局部肿胀，随后面部和眼睑逐渐肿胀，其影像学检查结果显示全身多处肌肉受损。最终病理结果提示NK/T细胞淋巴瘤，免疫组化显示CD20（-）、CD3Ɛ（+）、CD30（+）、CD56（-）、EBER（+）、Ki67（60%）、TIA-1（+）和CD68（±）染色。化疗方案治疗后肌肉肿胀明显改善。
结论
本病诊断困难且侵袭性强，应列入不明原因肌肉肿胀的鉴别诊断。
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