Concurrent Epstein-Barr virus associated NK/T cell lymphoma after immunosuppressive therapy for aplastic anemia: report of a case and review of literature.

Abstract

Aplastic anemia (AA) patients with prolonged immunosuppression have a risk of development of lymphoproliferative disorders (LPDs), especially combined with Epstein-Barr virus (EBV) infection. However, development of nature killer/T (NK/T) cell lymphoma, in a nontransplantation setting, has not been documented for AA patients with immunosuppressive therapy (IST). Herein, we described a middle-aged man, Han ethnic, who presented with swelled parotid gland after a long history of IST for AA. Fever, night sweating, weight loss had not been found. Increased heterotypic lymphocytes had been detected in the left side of parotid gland demonstrated as cCD3(+), CD56(+), GranB(+), TIA-1(+), MUM-1(+), KI-67 (50%-75%)(++), Bcl-6(-), MPO(-) by immunohistochemistry, and in-situ hybridization (ISH) indicated EBER positive. Chromosome analysis by R banding method revealed 46, XY [20]. NK/T cell lymphoma concurrent with aplastic anemia was diagnosed and a mild chemotherapy regimen including vincristine, prednisone, L-asparaginase was administered. The parotid mass was gradually regressed after the first cycle of chemotherapy. The patient discharged from the hospital voluntarily and lost the follow-up.

• Authors: Guangli Yin, Ying Ni, Zhengrui Xiao, Guangsheng He, Kourong Miao
• Journal: International journal of clinical and experimental pathology (Int J Clin Exp Pathol) Vol. 8 Issue 6 Pg. 7588-93 ( 2015) ISSN: 1936-2625 [Electronic] United States
• PMID: 26261674 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Biomarkers, Tumor
• Immunosuppressive Agents
• RNA, Viral

Topics

• Adult
• Anemia, Aplastic (diagnosis, drug therapy, immunology)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biomarkers, Tumor (analysis)
• Bone Marrow Examination
• Epstein-Barr Virus Infections (diagnosis, immunology, virology)
• Herpesvirus 4, Human (genetics, immunology, pathogenicity)
• Humans
• Immunocompromised Host
• Immunohistochemistry
• Immunosuppressive Agents (adverse effects)
• In Situ Hybridization
• Lymphoma, Extranodal NK-T-Cell (chemistry, diagnosis, drug therapy, immunology, virology)
• Male
• RNA, Viral (genetics)
• Treatment Outcome