Li Qing, Zhang Yunxiao, Sun Hui, Wang Xue, Wu Di
Department of Pathology, Xuzhou Central Hospital, Xuzhou, Jiangsu.
Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, Jiangsu.
Cytojournal. 2025 Feb 11;22:14. doi: 10.25259/Cytojournal_177_2024. eCollection 2025.
Our goal was to investigate the clinicopathological features of extranodal natural killer (NK)/T-cell lymphoma (ENKTL).
A total of five newly identified (5 biopsy samples) untreated cases of pulmonary ENKTL were collected between January 2016 and January 2024. The clinical characteristic pathology features on hematoxylin-eosin-staining sections, immunohistochemistry stating, treatment responses, and prognoses were retrospectively analyzed.
Among the five patients, four were male and one was female, and their ages varied between 48 and 63 years. All five patients were initially diagnosed with stage IV disease. Histological examination revealed either scattered or localized clusters of highly pleomorphic tumor lymphocytes associated with necrosis and a significant presence of inflammatory cells. Most tumor cells expressed cluster of differentiation (CD)3, T-cell intracellular antigen-1, and granzyme B, whereas there was an absence of CD20, CD79a, or CD5 expression. The expression of CD56 was detected in four out of the five patients. Only two patients were tested for programmed cell death ligand 1, with one out of two patients exhibiting positivity (Tumor Proportion Score (TPS) 80%). The Ki-67 proliferation index varied from 40% to 90%. All patients tested positive for Epstein- Barr virus-encoded ribonucleic acid (RNA) (EBER) through fluorescence hybridization (FISH). Five of the patients died during follow-up. Four of these patients underwent standard chemotherapy, with survival durations ranging from 3 to 24 months. One patient received only supportive treatment, resulting in a survival time of 1 month.
Pulmonary ENKTL is an uncommon, aggressive cancer associated with a bleak prognosis. The likelihood of misdiagnosis is high because of the presence of necrotic lesions and various cell types. Accurate diagnosis relies heavily on immunohistochemistry and EBER FISH. The aim of our study was to facilitate improved diagnosis of pulmonary ENKTL and to identify treatment strategies for affected individuals.
我们的目标是研究结外自然杀伤（NK）/T细胞淋巴瘤（ENKTL）的临床病理特征。
收集了2016年1月至2024年1月期间新确诊的（5份活检样本）5例未经治疗的肺ENKTL病例。对苏木精-伊红染色切片上的临床特征、病理特征、免疫组化结果、治疗反应和预后进行回顾性分析。
5例患者中，4例为男性，1例为女性，年龄在48至63岁之间。所有5例患者最初均被诊断为IV期疾病。组织学检查显示散在或局部聚集的高度多形性肿瘤淋巴细胞，伴有坏死和大量炎症细胞。大多数肿瘤细胞表达分化簇（CD）3、T细胞胞内抗原-1和颗粒酶B，而不存在CD20、CD79a或CD5表达。5例患者中有4例检测到CD56表达。仅2例患者检测了程序性细胞死亡配体1，其中1例呈阳性（肿瘤比例评分（TPS）80%）。Ki-67增殖指数在40%至90%之间。所有患者通过荧光原位杂交（FISH）检测爱泼斯坦-巴尔病毒编码核糖核酸（RNA）（EBER）均呈阳性。5例患者在随访期间死亡。其中4例患者接受了标准化疗，生存时间为3至24个月。1例患者仅接受了支持性治疗，生存时间为1个月。
肺ENKTL是一种罕见的侵袭性癌症，预后不佳。由于存在坏死性病变和多种细胞类型，误诊的可能性很高。准确诊断在很大程度上依赖于免疫组化和EBER FISH。我们研究的目的是促进肺ENKTL的诊断改善，并为受影响个体确定治疗策略。
