Primary pulmonary extranodal NK/T-cell lymphoma of nasal type misdiagnosed as pneumonia: A case report and literature review. Issue 49 (December 2017)

• Record Type: Journal Article
• Authors: Zhang, Juan; Wang, MaoJuan; Yang, XiaoDong; Liu, Chang; He, Xin
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 96:Issue 49(2017)
• Publication Date: 2017-12
• Subjects: extranodal NK/T cell lymphoma -- literature review -- misdiagnose -- pneumonia; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000008914
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Primary pulmonary NK/T cell lymphoma is extremely rare, and only a few cases have reported so far. Its diagnosis is mainly dependent on open-lung biopsy. Patient concerns: Here, we report a 44-year-old male who was initially misdiagnosed as having pneumonia according to the clinical characteristics and computed tomography (CT) findings. Diagnosis: The first lung biopsy indicated a large number of coagulative necrotic lesions, and definite diagnosis was made after the second lung biopsy following non-response to 6-day wide spectrum antibiotic therapy. The second lung biopsy showed the tumor cells were positive for LCA, CD3ε, CD30, TIA-1, Ki67 and negative for CD20, CD56, CD1a, MPO, CK, S-100, desmin, and CD34. Interventions: This patient refused to receive further therapy and died 1 month after confirmed diagnosis. Outcomes: Clinically, it is difficult to differentiate pneumonia from NK/T cell lymphoma in pathology due to the presence of plenty of focal necrosis in primary pulmonary NK/T cell lymphoma. Lessons: The diagnosis of primary pulmonary NK/T cell lymphoma should be based on lung biopsy (usually multiple lung biopsies are required), immunohistochemistry and clinical and imaging findings.