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Case report
peer-reviewed

Extranodal Natural Killer/T-Cell Lymphoma: An Incidental Finding



Abstract

Extranodal natural killer/T-cell lymphoma (ENKTCL) is a rare form of non-Hodgkin lymphoma. This neoplasm is more prevalent in regions of Asia and Latin America and most commonly involves the sinonasal tract, presenting with signs of nasal obstruction, epistaxis, or sinus infection. It is a locally destructive and angioinvasive neoplasm. The treatment of ENKTCL is dependent on the extent of the tumor. For localized disease, the treatment is chemoradiation. For disseminated disease, treatment is mainly chemotherapy-based. This report describes a case of a 41-year-old Hispanic woman who initially presented with signs of nasal congestion for four weeks and was subsequently diagnosed and treated for chronic sinusitis. The patient underwent endoscopic surgery for persistent chronic sinusitis, with a presumptive diagnosis of allergic fungal rhinosinusitis based on clinical and radiographic presentation. The pathologic exam revealed a diagnosis of ENKTCL. The patient underwent three cycles of chemotherapy comprised of steroid (hydrocortisone), methotrexate, ifosfamide, pre-asparaginase, and etoposide (SMILE) followed by radiation, resulting in clinical and radiographic remission. On review of the literature, ENKTCL is very rare in the United States and diagnosis is commonly delayed due to non-specific signs. We report this case to increase awareness of this disease entity and remind clinicians to include this in the differential diagnosis of nasal obstruction. 



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Case report
peer-reviewed

Extranodal Natural Killer/T-Cell Lymphoma: An Incidental Finding


Author Information

Ashley Althoff Corresponding Author

Medical Student, LECOM Bradenton

Michael Bibliowicz

Otolaryngology, Florida Hospital-Orlando


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.

Acknowledgements

Histology slides and descriptions were provided by David E. Ward, D.O., Department of Pathology, Florida Hospital, Orlando, FL.


Case report
peer-reviewed

Extranodal Natural Killer/T-Cell Lymphoma: An Incidental Finding


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Case report
peer-reviewed

Extranodal Natural Killer/T-Cell Lymphoma: An Incidental Finding

  • Author Information
    Ashley Althoff Corresponding Author

    Medical Student, LECOM Bradenton

    Michael Bibliowicz

    Otolaryngology, Florida Hospital-Orlando


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements

    Histology slides and descriptions were provided by David E. Ward, D.O., Department of Pathology, Florida Hospital, Orlando, FL.


    Article Information

    Published: May 19, 2017

    DOI

    10.7759/cureus.1260

    Cite this article as:

    Althoff A, Bibliowicz M (May 19, 2017) Extranodal Natural Killer/T-Cell Lymphoma: An Incidental Finding . Cureus 9(5): e1260. doi:10.7759/cureus.1260

    Publication history

    Received by Cureus: April 22, 2017
    Peer review began: May 02, 2017
    Peer review concluded: May 14, 2017
    Published: May 19, 2017

    Copyright

    © Copyright 2017
    Althoff et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Extranodal natural killer/T-cell lymphoma (ENKTCL) is a rare form of non-Hodgkin lymphoma. This neoplasm is more prevalent in regions of Asia and Latin America and most commonly involves the sinonasal tract, presenting with signs of nasal obstruction, epistaxis, or sinus infection. It is a locally destructive and angioinvasive neoplasm. The treatment of ENKTCL is dependent on the extent of the tumor. For localized disease, the treatment is chemoradiation. For disseminated disease, treatment is mainly chemotherapy-based. This report describes a case of a 41-year-old Hispanic woman who initially presented with signs of nasal congestion for four weeks and was subsequently diagnosed and treated for chronic sinusitis. The patient underwent endoscopic surgery for persistent chronic sinusitis, with a presumptive diagnosis of allergic fungal rhinosinusitis based on clinical and radiographic presentation. The pathologic exam revealed a diagnosis of ENKTCL. The patient underwent three cycles of chemotherapy comprised of steroid (hydrocortisone), methotrexate, ifosfamide, pre-asparaginase, and etoposide (SMILE) followed by radiation, resulting in clinical and radiographic remission. On review of the literature, ENKTCL is very rare in the United States and diagnosis is commonly delayed due to non-specific signs. We report this case to increase awareness of this disease entity and remind clinicians to include this in the differential diagnosis of nasal obstruction. 



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Create a free account to continue reading this article.

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Ashley Althoff, Medical Student

Medical Student, LECOM Bradenton

For correspondence:
ashley.althoff@med.lecom.edu

Michael Bibliowicz

Otolaryngology, Florida Hospital-Orlando

Ashley Althoff, Medical Student

Medical Student, LECOM Bradenton

For correspondence:
ashley.althoff@med.lecom.edu

Michael Bibliowicz

Otolaryngology, Florida Hospital-Orlando