Extranodal NK/T-cell Lymphoma Mimicking Granulomatous Myositis

Internal Medicine
Norihiko KawaguchiIchiro Nakashima

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.

References

Jul 9, 1999·American Journal of Clinical Pathology·R A Prayson
Mar 23, 2000·Journal of Neurology, Neurosurgery, and Psychiatry·T Mozaffar, A Pestronk
Oct 18, 2002·Histopathology·C S ChimY L Kwong
Oct 28, 2006·Muscle & Nerve·Karine Le RouxPascal Sève
May 19, 2007·American Journal of Clinical Pathology·Robert P Hasserjian, Nancy Lee Harris

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Methods Mentioned

BETA
biopsy
biopsies

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