Korean J Intern Med.
2007 Sep;22(3):201-205. 10.3904/kjim.2007.22.3.201.
Mediastinal Single Nodal Relapse of a Nasal Nk/T cell Lymphoma
- Affiliations
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- 1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. csuh@amc.seoul.kr
- 2Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
- 3Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
- 4Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
- KMID: 1785628
- DOI: http://doi.org/10.3904/kjim.2007.22.3.201
Abstract
- A nasal NK/T cell lymphoma is a very aggressive form of lymphoma. Patterns of relapse after treatment have not been systematically evaluated, and mediastinal nodal relapse at a primary site has never been documented. We describe here a 40-year old man who presented with a nasal obstruction caused by a protruding mass that was identified as a nasal NK/T cell lymphoma. The initial work-up, including chest and abdominopelvic computed tomography (CT) and positron emission tomography (PET), showed no regional or distant metastasis. A CT scan performed following three cycles of chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) showed that the mass had nearly disappeared. Radiation therapy undertaken following chemotherapy was given to the primary site. However, PET performed following radiotherapy revealed a single mediastinal lymphadenopathy, with no evidence of residual tumor in the nasal cavity. A biopsy using video-assisted thoracoscopy (VATS) showed the presence of a recurrent NK/T cell lymphoma with an immunophenotype identical to that of the primary nasal lymphoma. An additional three cycles of CHOP chemotherapy were administered, and the patient remains alive, with no evidence of disease 30 months after the initial relapse. These findings indicate that early detection with PET and prompt surgical excision with the use of VATS can lead to successful treatment of a relapsed nasal NK/T cell lymphoma.
Keyword
MeSH Terms
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Adult
Antineoplastic Combined Chemotherapy Protocols/*administration & dosage
Combined Modality Therapy
Cyclophosphamide/administration & dosage
Doxorubicin/administration & dosage
Humans
Lymphatic Metastasis
Lymphoma, Extranodal NK-T-Cell/*diagnosis/*therapy
Male
Nose Neoplasms/*diagnosis/*therapy
Positron-Emission Tomography
Prednisolone/administration & dosage
Radiotherapy, Adjuvant
Tomography, X-Ray Computed
Vincristine/administration & dosage
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