OBJECTIVE

To report a case of Mucosa-Associated Lymphoid Tissue (MALT) lymphoma of the nasopharynx in a young woman, and its clinical presentation, laboratory findings and management.

METHODS

Design: Case Report Report

Setting: Tertiary Government Training Hospital

Patient: One

RESULTS

A 21-year-old woman with a four-month history of right lateral neck mass managed as a case of clinically diagnosed pulmonary tuberculosis consulted us. Nasal endoscopy showed an erythematous, non-ulcerating exophytic mass in the nasopharynx. Histopathologic, immunohistochemical and PET-CT imaging studies confirmed MALT. She completed seven sessions of chemotherapy and is currently in complete remission.

CONCLUSION

MALT lymphoma of the nasopharynx is rare and may mimic other head and neck tumors both clinically and histologically. A high index of suspicion, thorough examination of Waldeyer’s ring, and confirmatory immunohistochemistry are essential for timely and accurate diagnosis of this uncommon but treatable malignancy.

Human ; Female ; Young Adult: 19-24 Yrs Old ; Malt Lymphoma ; Lymphoma, B-cell, Marginal Zone ; Extranodal Marginal Zone Lymphoma ; Nasopharynx

OBJECTIVETo study the clinicopathologic features, immunohistochemical findings, differential diagnosis and prognosis of type II enteropathy-associated T-cell lymphoma (EATL).

METHODSFourteen cases of type II EATL encountered in Department of Pathology, Nanjing General Hospital were retrospectively reviewed. The clinical data, histologic features, immunohistochemical findings and follow-up information were analyzed, with literature review.

RESULTSThere were altogether 12 males and 2 females. The median age of patient was 49 years. The sites of involvement included jejunum (10 cases) and ileum/colon (4 cases). The patients often presented with an abdominal mass, abdominal pain, diarrhea and constitutional symptoms such as fever, night sweating and cachexia. There was no clinical evidence of gluten-sensitive enteropathy. Histologically, the lymphoma cells showed full-thickness infiltration of the intestinal wall. They contained round hyperchromatic nuclei and pale cytoplasm. The stroma was minimally inflamed, with or without associated coagulative necrosis. A remarkable finding was the presence of villous atrophy, cryptal hyperplasia and intraepithelial lymphocytosis. Immunohistochemical study showed that the tumor cells expressed CD3, CD43 and CD8 (14/14). Some of them were also positive for CD56 (11/14) and CD30 (2/14). The staining for CD4, CD20, CD79a and myeloperoxidase was negative. A high proliferation index was demonstrated by Ki-67 immunostain. In-situ hybridization for EBER was negative. Follow-up data were available in 9 cases. The duration of follow-up ranged from 6 months to 36 months. Seven patients died within 14 months.

CONCLUSIONSEATL is a rare type of lymphoma with intestinal involvement. Associated enteropathy is not demonstrated, in contrast to cases encountered in Nordic countries. A correct diagnosis requires evaluation of clinical manifestations, pathologic features and ancillary study results.

Adolescent ; Adult ; Aged ; CD3 Complex ; metabolism ; CD8 Antigens ; metabolism ; Diagnosis, Differential ; Enteropathy-Associated T-Cell Lymphoma ; genetics ; immunology ; pathology ; surgery ; Female ; Follow-Up Studies ; Gene Rearrangement, T-Lymphocyte ; Humans ; Ileal Neoplasms ; genetics ; immunology ; pathology ; surgery ; Jejunal Neoplasms ; genetics ; immunology ; pathology ; surgery ; Leukosialin ; metabolism ; Lymphoma, B-Cell, Marginal Zone ; metabolism ; pathology ; Lymphoma, Extranodal NK-T-Cell ; metabolism ; pathology ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult