Ye Dan, Liu Xuhui, Yang Yuexiang, Yang Yang, Fei Zhentao, Liu Huarui, Zhan Qilin, Xia Lu
Department of Tuberculosis, Shanghai Public Health Clinical Center, Shanghai, China.
Department of Pathology, Shanghai Public Health Clinical Center, Shanghai, China.
Front Oncol. 2025 Jun 3;15:1529049. doi: 10.3389/fonc.2025.1529049. eCollection 2025.
Extranodal NK/T-cell lymphoma(ENKTCL) and diffuse large B-cell lymphoma(DLBCL) are specific subtypes of non-Hodgkin lymphoma(NHL), which lack specific features and are difficult to diagnose. The clinical features of lymphoma and tuberculosis are similar, which are easy to be misdiagnosed and lead to delayed treatment. This report describes two cases, one that of a 34-year-old man who was diagnosed with epididymal tuberculosis because of fever, progressive epididymal enlargement, positive T-cell Spot Test(T-SPOT), and epididymal magnetic resonance imaging(MRI) suggesting possible epididymal tuberculosis. He was treated with anti-tuberculosis therapy for 1 month, but the patient's epididymis continued to grow. Needle biopsy pathology and immunochemical examination showed an epididymal NK/T cell lymphoma, which gradually shrank after chemotherapy. Meanwhile, a 77-year-old female patient was reported who was diagnosed with adrenal tuberculosis because of fever, night sweats, abdominal pain, positive QuantiFERON-TB Gold(QFT) test, and adrenal tuberculosis detected by positron emission tomography/computed tomography(PET/CT). She received anti-tuberculosis treatment for 2 weeks, but her symptoms were not improved. Biopsy pathology and immunochemical examination showed adrenal diffuse large B-cell lymphoma, which deteriorated rapidly after chemotherapy and she finally died. In this report, epididymal NK/T cell lymphoma and adrenal diffuse large B-cell lymphoma are rare, and the disease develops rapidly. The diagnosis depends on pathological morphology and immunohistochemistry. Early detection, diagnosis, and treatment are crucial for the prognosis of patients.
结外NK/T细胞淋巴瘤（ENKTCL）和弥漫性大B细胞淋巴瘤（DLBCL）是非霍奇金淋巴瘤（NHL）的特定亚型，缺乏特异性特征，难以诊断。淋巴瘤和结核病的临床特征相似，容易误诊并导致治疗延误。本报告描述了两例病例，一例是一名34岁男性，因发热、附睾进行性肿大、T细胞斑点试验（T-SPOT）阳性以及附睾磁共振成像（MRI）提示可能为附睾结核而被诊断为附睾结核。他接受了1个月的抗结核治疗，但患者的附睾仍持续增大。穿刺活检病理及免疫化学检查显示为附睾NK/T细胞淋巴瘤，化疗后逐渐缩小。同时，报告了一名77岁女性患者，因发热、盗汗、腹痛、结核感染T细胞检测（QFT）试验阳性以及正电子发射断层扫描/计算机断层扫描（PET/CT）检测到肾上腺结核而被诊断为肾上腺结核。她接受了2周的抗结核治疗，但症状未改善。活检病理及免疫化学检查显示为肾上腺弥漫性大B细胞淋巴瘤，化疗后病情迅速恶化，最终死亡。在本报告中，附睾NK/T细胞淋巴瘤和肾上腺弥漫性大B细胞淋巴瘤较为罕见，疾病发展迅速。诊断依赖于病理形态学和免疫组织化学。早期发现、诊断和治疗对患者的预后至关重要。
