Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type, with Primary Manifestation as an Upper Eyelid Swelling
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- Kanzaki Akiko
- Department of Dermatology, Nippon Medical School
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- Funasaka Yoko
- Department of Dermatology, Nippon Medical School
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- Nakamizo Munenaga
- Department of Otorhinolaryngology, Nippon Medical School
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- Shima Ayaka
- Division of Hematology, Department of Internal Medicine, Nippon Medical School
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- Ryotokuji Takeshi
- Division of Hematology, Department of Internal Medicine, Nippon Medical School
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- Dan Kazuo
- Division of Hematology, Department of Internal Medicine, Nippon Medical School
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- Terasaki Mika
- Department of Analytic Human Pathology, Nippon Medical School
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- Sugisaki Yuichi
- Department of Analytic Human Pathology, Nippon Medical School
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- Fukuda Yu
- Department of Analytic Human Pathology, Nippon Medical School
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- Kawana Seiji
- Department of Dermatology, Nippon Medical School
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- Saeki Hidehisa
- Department of Dermatology, Nippon Medical School
抄録
<p>Extranodal natural killer/T-cell lymphoma (ENK/TCL) is most often in the nose or the nasopharynx but can present elsewhere. We report a rare case of ENK/TCL that presented as swelling of an upper eyelid without ocular involvement. A 76-year-old man visited our hospital with a swollen lesion of the left upper eyelid which had appeared 2 months earlier. A biopsy of the upper eyelid revealed slight perivascular and periadnexal infiltration of mononuclear cells with dermal edema. Treatment with oral prednisolone at a dosage of 20 mg/day decreased the eyelid swelling. However, 5 months later, exacerbation of the swelling and nasal congestion were observed. A second biopsy of the upper eyelid revealed a diffuse dermal infiltrate composed of mononuclear cells with an angiocentic growth pattern. Immunohistochemical studies and in situ hybridization showed natural killer-lineage antigens (CD56, granzyme B, and T-cell intracellular antigen 1) with expression of Epstein-Barr virus. These findings lead to the diagnosis of ENK/TCL. We treated the patient with radiation therapy (50 Gy) and 3 courses of a regimen including dexamethasone, carboplatin, etoposide, and ifosphamide. This case suggests that ENK/TCL can present with swelling of an upper eyelid as the primary sign of the skin lesion. Swelling of an upper eyelid should be considered in the differential diagnosis of ENK/TCL.</p>
収録刊行物
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- 日医大誌
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日医大誌 83 (4), 177-179, 2016
日本医科大学医学会