Extranodal NK/T-cell Lymphoma Mimicking Granulomatous Myositis
Extranodal NK/T-cell lymphoma (ENKTL) is an aggressive non-Hodgkin lymphoma that typically develops in the upper aerodigestive tract. We encountered an ENKTL patient who presented with generalized muscle weakness with eyelid swelling, diplopia, and facial edema. A muscle biopsy revealed lymphocytic...
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| Veröffentlicht in: | Internal Medicine 2019/01/15, Vol.58(2), pp.277-282 |
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| creator | Kawaguchi, Norihiko Izumi, Rumiko Kobayashi, Masahiro Tateyama, Maki Suzuki, Naoki Fujishima, Fumiyoshi Fujimori, Juichi Aoki, Masashi Nakashima, Ichiro |
| description | Extranodal NK/T-cell lymphoma (ENKTL) is an aggressive non-Hodgkin lymphoma that typically develops in the upper aerodigestive tract. We encountered an ENKTL patient who presented with generalized muscle weakness with eyelid swelling, diplopia, and facial edema. A muscle biopsy revealed lymphocytic infiltration without significant atypia; some lymphocytes formed granuloma-like structures. Although the initial response to steroids was encouraging, an ulcerative eruption appeared in the thigh, and a skin biopsy revealed lymphocytes with atypia. A re-analysis of the muscle biopsy with additional immunohistochemistry revealed neoplastic NK/T lymphocytes in the granulomatous structures. Our case highlights the significance of re-evaluating muscle biopsy specimens in cases of atypical myositis. |
| doi_str_mv | 10.2169/internalmedicine.0859-18 |
| format | Article |
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We encountered an ENKTL patient who presented with generalized muscle weakness with eyelid swelling, diplopia, and facial edema. A muscle biopsy revealed lymphocytic infiltration without significant atypia; some lymphocytes formed granuloma-like structures. Although the initial response to steroids was encouraging, an ulcerative eruption appeared in the thigh, and a skin biopsy revealed lymphocytes with atypia. A re-analysis of the muscle biopsy with additional immunohistochemistry revealed neoplastic NK/T lymphocytes in the granulomatous structures. Our case highlights the significance of re-evaluating muscle biopsy specimens in cases of atypical myositis.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.0859-18</identifier><identifier>PMID: 30146568</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>Biopsy ; Case Report ; Diplopia - etiology ; Edema ; Edema - etiology ; extranodal NK/T-cell lymphoma (ENKTL) ; Eyelid ; eyelid swelling ; Eyelids - pathology ; Granuloma ; Granuloma - diagnosis ; granulomatous myositis ; Humans ; Immunohistochemistry ; Internal medicine ; Lymphocytes ; Lymphocytes T ; Lymphoma ; Lymphoma, Extranodal NK-T-Cell - complications ; Lymphoma, Extranodal NK-T-Cell - diagnosis ; Lymphoma, Extranodal NK-T-Cell - pathology ; Male ; Middle Aged ; Mimicry ; muscle biopsy ; Muscle Weakness - etiology ; Muscles ; Myositis ; Myositis - diagnosis ; Natural killer cells ; Non-Hodgkin's lymphoma ; Skin ; Steroid hormones ; Steroids ; T-cell lymphoma</subject><ispartof>Internal Medicine, 2019/01/15, Vol.58(2), pp.277-282</ispartof><rights>2019 by The Japanese Society of Internal Medicine</rights><rights>Copyright Japan Science and Technology Agency 2019</rights><rights>Copyright © 2019 by The Japanese Society of Internal Medicine 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c609t-c5301cb4e535e61d42f7345c9d561c1c1b01a6a1117857881a26b5fd14495b53</citedby><cites>FETCH-LOGICAL-c609t-c5301cb4e535e61d42f7345c9d561c1c1b01a6a1117857881a26b5fd14495b53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378152/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378152/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,1881,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30146568$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kawaguchi, Norihiko</creatorcontrib><creatorcontrib>Izumi, Rumiko</creatorcontrib><creatorcontrib>Kobayashi, Masahiro</creatorcontrib><creatorcontrib>Tateyama, Maki</creatorcontrib><creatorcontrib>Suzuki, Naoki</creatorcontrib><creatorcontrib>Fujishima, Fumiyoshi</creatorcontrib><creatorcontrib>Fujimori, Juichi</creatorcontrib><creatorcontrib>Aoki, Masashi</creatorcontrib><creatorcontrib>Nakashima, Ichiro</creatorcontrib><title>Extranodal NK/T-cell Lymphoma Mimicking Granulomatous Myositis</title><title>Internal Medicine</title><addtitle>Intern. Med.</addtitle><description>Extranodal NK/T-cell lymphoma (ENKTL) is an aggressive non-Hodgkin lymphoma that typically develops in the upper aerodigestive tract. We encountered an ENKTL patient who presented with generalized muscle weakness with eyelid swelling, diplopia, and facial edema. A muscle biopsy revealed lymphocytic infiltration without significant atypia; some lymphocytes formed granuloma-like structures. Although the initial response to steroids was encouraging, an ulcerative eruption appeared in the thigh, and a skin biopsy revealed lymphocytes with atypia. A re-analysis of the muscle biopsy with additional immunohistochemistry revealed neoplastic NK/T lymphocytes in the granulomatous structures. Our case highlights the significance of re-evaluating muscle biopsy specimens in cases of atypical myositis.</description><subject>Biopsy</subject><subject>Case Report</subject><subject>Diplopia - etiology</subject><subject>Edema</subject><subject>Edema - etiology</subject><subject>extranodal NK/T-cell lymphoma (ENKTL)</subject><subject>Eyelid</subject><subject>eyelid swelling</subject><subject>Eyelids - pathology</subject><subject>Granuloma</subject><subject>Granuloma - diagnosis</subject><subject>granulomatous myositis</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Internal medicine</subject><subject>Lymphocytes</subject><subject>Lymphocytes T</subject><subject>Lymphoma</subject><subject>Lymphoma, Extranodal NK-T-Cell - complications</subject><subject>Lymphoma, Extranodal NK-T-Cell - diagnosis</subject><subject>Lymphoma, Extranodal NK-T-Cell - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mimicry</subject><subject>muscle biopsy</subject><subject>Muscle Weakness - etiology</subject><subject>Muscles</subject><subject>Myositis</subject><subject>Myositis - diagnosis</subject><subject>Natural killer cells</subject><subject>Non-Hodgkin's lymphoma</subject><subject>Skin</subject><subject>Steroid hormones</subject><subject>Steroids</subject><subject>T-cell lymphoma</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkV9v0zAUxS0EYmXwFVAkXnjJ5ut_sV8moWkMRDde-m45jtu6JHaxk4l-exy1VDBk6Vqyfz73Hh-EKsBXBIS69mF0KZh-cJ23PrgrLLmqQb5AC6BM1Q2h_CVaYAWyJqVcoDc57zCmslHkNbqgGJjgQi7Qzd2vMZkQO9NXj9-uV7V1fV8tD8N-GwdTPfjB2x8-bKr7Qk19ORvjlKuHQ8x-9PkterU2fXbvTvslWn2-W91-qZff77_eflrWVmA11paXjrZljlPuBHSMrBvKuFUdF2DLajEYYQCgkbyREgwRLV93wJjiLaeX6OYou5_a4tm6UIbu9T75waSDjsbrf2-C3-pNfNKCNhI4KQIfTwIp_pxcHvXg82zVBFf8aIIVY-VruSzoh2foLk7zZxeKMKGAKMoKJY-UTTHn5NbnYQDrOSP9PCM9Z6RhbvD-bzPnh39CKcDjEdjl0WzcGTBp9LZ3_ytzqclcTh3OoN2apF2gvwGq8K9T</recordid><startdate>20190115</startdate><enddate>20190115</enddate><creator>Kawaguchi, Norihiko</creator><creator>Izumi, Rumiko</creator><creator>Kobayashi, Masahiro</creator><creator>Tateyama, Maki</creator><creator>Suzuki, Naoki</creator><creator>Fujishima, Fumiyoshi</creator><creator>Fujimori, Juichi</creator><creator>Aoki, Masashi</creator><creator>Nakashima, Ichiro</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190115</creationdate><title>Extranodal NK/T-cell Lymphoma Mimicking Granulomatous Myositis</title><author>Kawaguchi, Norihiko ; Izumi, Rumiko ; Kobayashi, Masahiro ; Tateyama, Maki ; Suzuki, Naoki ; Fujishima, Fumiyoshi ; Fujimori, Juichi ; Aoki, Masashi ; Nakashima, Ichiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c609t-c5301cb4e535e61d42f7345c9d561c1c1b01a6a1117857881a26b5fd14495b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Biopsy</topic><topic>Case Report</topic><topic>Diplopia - etiology</topic><topic>Edema</topic><topic>Edema - etiology</topic><topic>extranodal NK/T-cell lymphoma (ENKTL)</topic><topic>Eyelid</topic><topic>eyelid swelling</topic><topic>Eyelids - pathology</topic><topic>Granuloma</topic><topic>Granuloma - diagnosis</topic><topic>granulomatous myositis</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Internal medicine</topic><topic>Lymphocytes</topic><topic>Lymphocytes T</topic><topic>Lymphoma</topic><topic>Lymphoma, Extranodal NK-T-Cell - complications</topic><topic>Lymphoma, Extranodal NK-T-Cell - diagnosis</topic><topic>Lymphoma, Extranodal NK-T-Cell - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mimicry</topic><topic>muscle biopsy</topic><topic>Muscle Weakness - etiology</topic><topic>Muscles</topic><topic>Myositis</topic><topic>Myositis - diagnosis</topic><topic>Natural killer cells</topic><topic>Non-Hodgkin's lymphoma</topic><topic>Skin</topic><topic>Steroid hormones</topic><topic>Steroids</topic><topic>T-cell lymphoma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kawaguchi, Norihiko</creatorcontrib><creatorcontrib>Izumi, Rumiko</creatorcontrib><creatorcontrib>Kobayashi, Masahiro</creatorcontrib><creatorcontrib>Tateyama, Maki</creatorcontrib><creatorcontrib>Suzuki, Naoki</creatorcontrib><creatorcontrib>Fujishima, Fumiyoshi</creatorcontrib><creatorcontrib>Fujimori, Juichi</creatorcontrib><creatorcontrib>Aoki, Masashi</creatorcontrib><creatorcontrib>Nakashima, Ichiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Internal Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kawaguchi, Norihiko</au><au>Izumi, Rumiko</au><au>Kobayashi, Masahiro</au><au>Tateyama, Maki</au><au>Suzuki, Naoki</au><au>Fujishima, Fumiyoshi</au><au>Fujimori, Juichi</au><au>Aoki, Masashi</au><au>Nakashima, Ichiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extranodal NK/T-cell Lymphoma Mimicking Granulomatous Myositis</atitle><jtitle>Internal Medicine</jtitle><addtitle>Intern. Med.</addtitle><date>2019-01-15</date><risdate>2019</risdate><volume>58</volume><issue>2</issue><spage>277</spage><epage>282</epage><pages>277-282</pages><issn>0918-2918</issn><eissn>1349-7235</eissn><abstract>Extranodal NK/T-cell lymphoma (ENKTL) is an aggressive non-Hodgkin lymphoma that typically develops in the upper aerodigestive tract. We encountered an ENKTL patient who presented with generalized muscle weakness with eyelid swelling, diplopia, and facial edema. A muscle biopsy revealed lymphocytic infiltration without significant atypia; some lymphocytes formed granuloma-like structures. Although the initial response to steroids was encouraging, an ulcerative eruption appeared in the thigh, and a skin biopsy revealed lymphocytes with atypia. A re-analysis of the muscle biopsy with additional immunohistochemistry revealed neoplastic NK/T lymphocytes in the granulomatous structures. Our case highlights the significance of re-evaluating muscle biopsy specimens in cases of atypical myositis.</abstract><cop>Japan</cop><pub>The Japanese Society of Internal Medicine</pub><pmid>30146568</pmid><doi>10.2169/internalmedicine.0859-18</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biopsy Case Report Diplopia - etiology Edema Edema - etiology extranodal NK/T-cell lymphoma (ENKTL) Eyelid eyelid swelling Eyelids - pathology Granuloma Granuloma - diagnosis granulomatous myositis Humans Immunohistochemistry Internal medicine Lymphocytes Lymphocytes T Lymphoma Lymphoma, Extranodal NK-T-Cell - complications Lymphoma, Extranodal NK-T-Cell - diagnosis Lymphoma, Extranodal NK-T-Cell - pathology Male Middle Aged Mimicry muscle biopsy Muscle Weakness - etiology Muscles Myositis Myositis - diagnosis Natural killer cells Non-Hodgkin's lymphoma Skin Steroid hormones Steroids T-cell lymphoma |
| title | Extranodal NK/T-cell Lymphoma Mimicking Granulomatous Myositis |
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