Persistent Thrombocytopenia Post Autologous Transplant In A Case Of Extra Nodal Nk Cell Lymphoma
Keywords:
NK/T-cell non-Hodgkin lymphoma, Aggressive NK cell Leukemia, NHL
Abstract
Natural killer (NK)-cell lymphomas are a rare type of lymphoid malignancy with predominantly extranodal nasal involvement leading to destruction of midline head and neck structures. This article presents a case of extranodal nasal type NK cell lymphoma which even after aggressive treatment relapsed in leukemic form with no evidence of lesion at the primary site or any solid organ. This case report aims to highlight the importance of careful peripheral smear examination, knowledge of flow cytometry in early and accurate diagnosis of leukemic spillover of this rare entity and the need for aggressive treatment.
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References
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3. Au WY, Weisenburger DD, Intragumtornchai T, Nakamura S, Kim WS, Sng I, Vose J, Armitage JO, Liang R., International Peripheral T-Cell Lymphoma Project. Clinical differences between nasal and extranasal natural killer/T-cell lymphoma: a study of 136 cases from the International Peripheral T-Cell Lymphoma Project. Blood. 2009 Apr 23;113(17):3931-7.
4. Kim SJ, Jung HA, Chuang SS, Hong H, Guo CC, Cao J, Hong XN, Suzuki R, Kang HJ, Won JH, Chng WJ, Kwong YL, Suh C, Song YQ, Zhu J, Tay K, Lim ST, Suzumiya J, Lin TY, Kim WS., Asia Lymphoma Study Group. Extranodal natural killer/T-cell lymphoma involving the gastrointestinal tract: analysis of clinical features and outcomes from the Asia Lymphoma Study Group. J Hematol Oncol. 2013 Nov 16;6:86.
5. Fox CP, Civallero M, Ko YH, Manni M, Skrypets T, Pileri S, Kim SJ, Cabrera ME, Shustov AR, Chiattone CS, Horwitz SM, Dlouhy I, Spina M, Hitz F, Montoto S, Nagler A, Martinez V, De Souza CA, Fernandez-Alvarez R, Ballova V, Gabús R, Inghirami G, Federico M, Kim WS. Survival outcomes of patients with extranodal natural-killer T-cell lymphoma: a prospective cohort study from the international T-cell Project. Lancet Haematol. 2020 Apr;7(4):e284-e294.
6. Bhatt VR, Koirala B, Terjanian T. Extranodal natural killer/T cell lymphoma, nasal type presenting as a palatal perforation and naso-oral fistula. BMJ case reports. Mar ; pii: bcr1120103511.
7. Gru AA, Haverkos BH, Freud AG, Hastings J, Nowacki NB, Barrionuevo C, Vigil CE, Rochford R, Natkunam Y, Baiocchi RA, Porcu P. The Epstein-Barr Virus (EBV) in T Cell and NK Cell Lymphomas: Time for a Reassessment. Curr Hematol Malig Rep. 2015 Dec;10(4):456-67.
8. Zheng S, Ouyang Q, Li G, Xu H, Jiang M, Cui D, et al. Primary intestinal NK/T cell lymphoma: a clinicopathologic study of 25 Chinese cases. Arch Iran Med. (2012) 15:36–42.
9. Kim HS, Kim KH, Kim KH, Chang MH, Ji SH, Lim DH, Kim K, Kim SJ, Ko Y, Ki CS, Jo SJ, Lee JW, Kim WS. Whole blood Epstein-Barr virus DNA load as a diagnostic and prognostic surrogate: extranodal natural killer/T-cell lymphoma. Leuk Lymphoma. 2009 May;50(5):757-63.
10. Ding JJ, Chen YL, Zhou SH, Zhao K. Positron emission tomography/computed tomography in the diagnosis, staging, and prognostic evaluation of natural killer/T-cell lymphoma. J Int Med Res. 2018 Dec;46(12):4920-4929.
11. Jenny C. Hoffmann, Lauren S. Maeda, Robert S. Ohgami,13 - Indolent and Aggressive Mature T-Cell and Natural Killer–Cell Lymphomas, Editor(s): Mohamed Salama, Julie Teruya-Feldstein, Marina Kremyanskaya, Atlas of Diagnostic Hematology, Elsevier,2021, Pages 251-273, ISBN 9780323567381.
12. Ding JJ, Chen YL, Zhou SH, Zhao K. Positron emission tomography/computed tomography in the diagnosis, staging, and prognostic evaluation of natural killer/T-cell lymphoma. J Int Med Res. 2018 Dec;46(12):4920-4929.
13. Wei W, Wu P, Li L, Zhang ZH. Effectiveness of pegaspargase, gemcitabine, and oxaliplatin (P-GEMOX) chemotherapy combined with radiotherapy in newly diagnosed, stage IE to IIE, nasal-type, extranodal natural killer/T-cell lymphoma. Hematology. 2017 Jul;22(6):320-329.
14. Wong KF, Chan JK, Cheung MM, So JC. Bone marrow involvement by nasal NK cell lymphoma at diagnosis is uncommon. Am J Clin Pathol. 2001 Feb;115(2):266-70.
15. Jaffe ES, Nicolae A, Pittaluga S. Peripheral T-cell and NK-cell lymphomas in the WHO clasification: Pearls and pitfalls. Mod Pathol. 2013;26 (Suppl 1):S71–S87. doi: 10.1038/modpathol.2012.181
16. Hwang ST, Janik JE, Jaffe ES, Wilson WH. Mycosis fungoides and Sézary syndrome. Lancet. 2018;371:945–957.
How to Cite
K. Goel, D. D., Sabina Langer, Jyoti Kotwal, Amrita Saraf, & Pallavi Prakhar. (2024). Persistent Thrombocytopenia Post Autologous Transplant In A Case Of Extra Nodal Nk Cell Lymphoma. Tropical Journal of Pathology and Microbiology, 10(02), 14-19. Retrieved from https://pathology.medresearch.in/index.php/jopm/article/view/655
Section
Case Report
Copyright (c) 2024 Author (s). Published by Siddharth Health Research and Social Welfare Society
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