Yeh K H, Lien H C, Hsu S M, Cheng A L
Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Republic of China.
Am J Hematol. 1999 Feb;60(2):161-3. doi: 10.1002/(sici)1096-8652(199902)60:2<161::aid-ajh15>3.0.co;2-a.
A 57-year-old man was diagnosed as primary T/NK-cell central nervous system lymphoma (CNSL) with intraocular involvement. However, review of a surgical specimen taken three years before for chronic paranasal sinusitis revealed an overlooked nasal T/NK cell lymphoma (TNKL), which showed similar histomorphology and immunophenotype with the CNS disease. Another patient, a 43-year-old woman, was initially diagnosed as a rare primary leptomeningeal T-cell lymphoma with ocular manifestation. Three years later, an isolated nasal TNKL emerged. Immunohistochemical and cytogenetic studies confirmed the same nature of the CNSL and the nasal TNKL. The nasal TNKLs of both patients had a strong expression of CD3, CD56, and Epstein-Barr virus antigens, but features of angiodestruction and mucosal ulceration were absent. We propose that: 1. a locally silent "quiescent" form of nasal TNKL may exist; and 2. a thorough examination and even blind biopsy of the nasal cavity is indicated when primary T/NK-cell CNSL is diagnosed.
一名57岁男性被诊断为原发性T/NK细胞中枢神经系统淋巴瘤（CNSL）并累及眼内。然而，回顾三年前因慢性鼻旁窦炎所取的手术标本发现了一例被漏诊的鼻T/NK细胞淋巴瘤（TNKL），其组织形态学和免疫表型与中枢神经系统疾病相似。另一例患者为一名43岁女性，最初被诊断为罕见的原发性软脑膜T细胞淋巴瘤并伴有眼部表现。三年后，出现了孤立性鼻TNKL。免疫组织化学和细胞遗传学研究证实CNSL和鼻TNKL性质相同。两名患者的鼻TNKL均有CD3、CD56和爱泼斯坦-巴尔病毒抗原的强表达，但无血管破坏和黏膜溃疡特征。我们提出：1. 可能存在局部无症状的“静止”型鼻TNKL；2. 当诊断为原发性T/NK细胞CNSL时，应对鼻腔进行全面检查甚至盲目活检。
