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Primary pulmonary extranodal NK/T-cell lymphoma of nasal type misdiagnosed as pneumonia: A case report and literature review

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 chara...

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Detalles Bibliográficos
Autores principales: Zhang, Juan, Wang, MaoJuan, Yang, XiaoDong, Liu, Chang, He, Xin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728871/
https://www.ncbi.nlm.nih.gov/pubmed/29245256
http://dx.doi.org/10.1097/MD.0000000000008914
Descripción
Sumario: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.