Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2020; 8(1): 234-241
Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.234
Primary intestinal extranodal natural killer/T-cell lymphoma, nasal type: A case report
Bao-Long Dong, Xiao-Hua Dong, Hui-Qi Zhao, Peng Gao, Xiao-Jun Yang
Bao-Long Dong, Xiao-Hua Dong, Hui-Qi Zhao, Peng Gao, Xiao-Jun Yang, Department of General Surgery, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Author contributions: Dong BL and Dong XH contributed equally to this work; Dong BL and Zhao HQ designed the study; Yang XJ, Dong BL, Dong XH and Gao P performed the surgery; Dong BL and Dong XH performed postoperative follow-up; Yang XJ revised the manuscript; all authors read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81260326 and No. 81660398; and Natural Science Foundation of Gansu Province, No. 17JR5RA034.
Informed consent statement: All surgeries were performed after the patient or their relatives signed the informed consent form.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiao-Jun Yang, MD, PhD, Chief Doctor, Professor, Surgeon, Department of General Surgery, Gansu Provincial Hospital, No. 204 Donggang West Road, Lanzhou 730000, Gansu Province, China. yangxjmd@aliyun.com
Received: October 22, 2019
Peer-review started: October 22, 2019
First decision: November 11, 2019
Revised: November 14, 2019
Accepted: November 27, 2019
Article in press: November 27, 2019
Published online: January 6, 2020
Processing time: 77 Days and 0.3 Hours
Abstract
BACKGROUND

Primary intestinal extranodal natural killer/T-cell lymphoma, nasal type (PI-ENKTCL) is a rare non-Hodgkin’s lymphoma (NHL) subtype, and its prognosis is extremely poor. Clinical characteristics of the disease are not obvious and easily misdiagnosed. In this case report, we describe a patient with PI-ENKTCL who presented with intermittent hematochezia. The advantages of positron emission tomography/computed tomography (PET-CT) as a useful diagnostic tool and the role of surgery as an important therapy are highlighted.

CASE SUMMARY

A 45-year-old man, hospitalized due to intermittent hematochezia, underwent gastroscopy, colonoscopy, biopsy and CT, but no cause was found. Hence, we carried out a multidisciplinary team (MDT) discussion on the causes and treatment of this patient, and it was decided to perform PET-CT imaging with a MDT discussion of the results. PET-CT demonstrated a diagnosis of lymphoma and it was decided to surgically resect the lesion, and a R0 resection was successfully performed. Postoperative pathology showed negative resection margins, and examination of the lesion confirmed the diagnosis of PI-ENKTCL. After surgery, the patient underwent a follow-up period of 6 mo and received 6 cycles of gemcitabine, oxaliplatin and L-asparaginase. No recurrence or metastasis occurred.

CONCLUSION

PI-ENKTCL is rare, and MDT discussion is required during diagnosis. PET-CT can be performed for imaging diagnosis. Treatment is based on surgical resection, and the best treatment regimen is determined according to postoperative pathological results to improve prognosis and to extend survival in patients.

Keywords: Primary intestinal extranodal natural killer/T-cell lymphoma; Multidisciplinary team discussion; Rare disease; Case report

Core tip: Primary intestinal extranodal natural killer/T-cell lymphoma, nasal type (PI-ENKTCL) is a very rare disease and its prognosis is extremely poor. Due to its rarity, PI-ENKTCL has not been thoroughly investigated. Moreover, knowledge of its clinical characteristics is limited. Hence, we report a patient with PI-ENKTCL and review the corresponding literature to improve our knowledge of this disease and avoid misdiagnosis.