口蓋粘膜原発の節外性NK/T細胞リンパ腫, 鼻型の1例
Extranodal NK/T cell lymphoma, nasal type is a rare malignant lymphoma, especially in the oral cavity. It is characterized by a necrotizing ulcer, often strongly associated with Epstein-Barr virus. We describe a case of extranodal NK/T cell lymphoma, nasal type found because of antiphlogistic-resist...
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| Published in | 日本口腔外科学会雑誌 Vol. 59; no. 9; pp. 612 - 616 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
社団法人 日本口腔外科学会
20.09.2013
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5163 2186-1579 |
| DOI | 10.5794/jjoms.59.612 |
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| Abstract | Extranodal NK/T cell lymphoma, nasal type is a rare malignant lymphoma, especially in the oral cavity. It is characterized by a necrotizing ulcer, often strongly associated with Epstein-Barr virus. We describe a case of extranodal NK/T cell lymphoma, nasal type found because of antiphlogistic-resistant swelling in the palate. A 73-year-old man was referred to our hospital because of pain and swelling in the left side of the hard palate. Computed tomography showed no evidence of bone destruction, and the symptoms did not change after antibiotic therapy. Therefore, a biopsy was performed, and immunohistochemical analyses revealed positivity for CD56, TIA-1, EBER on in situ hybridization, CD45RO (UCHL1), and CD3 and negativity for CD79a and CD20 (L26). Four courses of DeVIC (CBDCA, VP-16, IFO, DEX) were administered to the patient. There has been no sign of recurrence after chemotherapy. This case demonstrates that antiphlogistic-resistant swelling with no inflammation in the oral cavity can be a clinical sign of extranodal NK/T cell lymphoma, nasal type. |
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| AbstractList | Extranodal NK/T cell lymphoma, nasal type is a rare malignant lymphoma, especially in the oral cavity. It is characterized by a necrotizing ulcer, often strongly associated with Epstein-Barr virus. We describe a case of extranodal NK/T cell lymphoma, nasal type found because of antiphlogistic-resistant swelling in the palate. A 73-year-old man was referred to our hospital because of pain and swelling in the left side of the hard palate. Computed tomography showed no evidence of bone destruction, and the symptoms did not change after antibiotic therapy. Therefore, a biopsy was performed, and immunohistochemical analyses revealed positivity for CD56, TIA-1, EBER on in situ hybridization, CD45RO (UCHL1), and CD3 and negativity for CD79a and CD20 (L26). Four courses of DeVIC (CBDCA, VP-16, IFO, DEX) were administered to the patient. There has been no sign of recurrence after chemotherapy. This case demonstrates that antiphlogistic-resistant swelling with no inflammation in the oral cavity can be a clinical sign of extranodal NK/T cell lymphoma, nasal type. |
| Author | 北村, 龍二 伊藤, 章 大西, 淑美 美馬, 淳子 石本, 俊介 松岡, 裕大 |
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| References | 8) 池田哲也，宮沢正純，他：上顎に発生したNK/T細胞リンパ腫の1例．日口外誌 52: 346-349, 2006. 3) Chen JKC, Quintanilla-Martinez L, et al : Extranodal NK/T-cell lymphoma, nasal type, In WHO classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC Press, Lyon, 2008, p285-288. 11) 金子貴広，増田一生，他：上顎歯肉と硬口蓋の壊死性潰瘍を伴った節外性NK/T細胞リンパ腫，鼻型の1例．日口外誌 57: 284-288, 2011. 15) 山口素子，水谷 実，他：いわゆるNK細胞リンパ腫．臨床血液 37: 417, 1996. 9) 大槻哲也，保田宗則，他：上唇に著明な腫脹をきたした鼻型NK/T細胞リンパ腫の1例．日口外誌 53: 514-518, 2007. 22) Yamaguchi M, Ogawa S, et al : Treatment outcome of nasal NK/T-cell lymphoma: A report of consectivelydiagnosed cases and a review of the literature. J Clin Exp Hematop 41: 93-99, 2001. 21) Suzuki R, Takeuchi K, et al : Extranodal NK/T-cell lymphoma: diagnosis and treatment cues. Hematol Oncol. 26: 66-72, 2008. 23) Yamaguchi M, Tobinai K, et al : Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: Japan Clinical Oncology Group Study JCOG0211. J Clin Oncol 20; 27: 5594-5600, 2009. 7) 立石康一郎，利谷幸治，他：両側上顎歯肉に壊死性潰瘍を生じた口蓋に発生した鼻型NK/T細胞リンパ腫の1例．日口外誌 48: 572-575, 2002. 19) 磯辺康司：NK/T細胞リンパ腫．Pharma Media 24: 145-148, 2006. 13) 山口素子：EBウイルスとリンパ網内系疾患；NK細胞リンパ腫．血腫瘍 56: 306-313, 2008. 4) 田畑雅彦，吉田 稔，他：歯肉への浸潤を初発症状としたNK細胞由来と考えられる悪性リンパ腫．癌の臨床 43: 968-972, 1997. 17) 鈴木淳司，田村和夫，他：NK細胞リンパ腫の臨床病態．血腫瘍 42: 319-324, 2001 12) 神津由直，山本亞有美，他：初期臨床像を観察し得た口蓋歯肉原発節外性NK/T細胞リンパ腫，鼻型の1例．日口外誌 57: 610-614, 2011. 1) Lymphoma Study Group of Japanese Pathologists: World Health Organization classification of malignant lymphomas in Japan: incidence of recently recognized entities. Pathol Int 50: 696-702, 2000. 2) Oshimi K, Kawa K, et al : NK-cell neoplasm in Japan. Hematol 10: 237-245, 2005. 5) 占部一彦，古郷幹彦，他：長期間再発性潰瘍の症状を呈した特異なNK/T細胞リンパ腫の1例．阪大歯学誌 46: 91-95, 2002. 6) 水柿雄三，早津良和，他：口蓋に発生した進行性鼻壊疽（T/NK細胞リンパ腫) の1例．日口外誌 48: 394-397, 2002. 10) 小西弘晃，松本剛一，他：下顎に広範な歯肉壊死を伴った節外性NK/T細胞リンパ腫の1例．日口外誌 54: 581-585, 2008. 18) 青笹克之，菅野祐幸，他：鼻腔NK細胞リンパ腫の病理・疫学．血腫瘍 40: 91-92, 2000. 20) Lee J, Suh C, et al : Extranodal natural killer-T cell lymphoma, nasal type; a prognostic model from a retrospective multicenter study. J Clin Oncol 24: 612-618, 2006. 16) 形浦昭克，原渕保明：進行性鼻壊疽 (鼻性T細胞リンパ腫) の本態と臨床．耳展 38: 541-565, 1995. 14) Kaneko T, Fukuda J, et al : Nasal natural killer (NK) cell lymphoma: report of a case with activated NK cells containing Epstein-Barr virus and expressing CD21 antigen, and comparative studies of their phenotype and cytotoxicity with normal NK cells. Br J Haematol 91: 355-361, 1995. |
| References_xml | – reference: 15) 山口素子，水谷 実，他：いわゆるNK細胞リンパ腫．臨床血液 37: 417, 1996. – reference: 22) Yamaguchi M, Ogawa S, et al : Treatment outcome of nasal NK/T-cell lymphoma: A report of consectivelydiagnosed cases and a review of the literature. J Clin Exp Hematop 41: 93-99, 2001. – reference: 9) 大槻哲也，保田宗則，他：上唇に著明な腫脹をきたした鼻型NK/T細胞リンパ腫の1例．日口外誌 53: 514-518, 2007. – reference: 14) Kaneko T, Fukuda J, et al : Nasal natural killer (NK) cell lymphoma: report of a case with activated NK cells containing Epstein-Barr virus and expressing CD21 antigen, and comparative studies of their phenotype and cytotoxicity with normal NK cells. Br J Haematol 91: 355-361, 1995. – reference: 10) 小西弘晃，松本剛一，他：下顎に広範な歯肉壊死を伴った節外性NK/T細胞リンパ腫の1例．日口外誌 54: 581-585, 2008. – reference: 1) Lymphoma Study Group of Japanese Pathologists: World Health Organization classification of malignant lymphomas in Japan: incidence of recently recognized entities. Pathol Int 50: 696-702, 2000. – reference: 3) Chen JKC, Quintanilla-Martinez L, et al : Extranodal NK/T-cell lymphoma, nasal type, In WHO classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC Press, Lyon, 2008, p285-288. – reference: 7) 立石康一郎，利谷幸治，他：両側上顎歯肉に壊死性潰瘍を生じた口蓋に発生した鼻型NK/T細胞リンパ腫の1例．日口外誌 48: 572-575, 2002. – reference: 8) 池田哲也，宮沢正純，他：上顎に発生したNK/T細胞リンパ腫の1例．日口外誌 52: 346-349, 2006. – reference: 11) 金子貴広，増田一生，他：上顎歯肉と硬口蓋の壊死性潰瘍を伴った節外性NK/T細胞リンパ腫，鼻型の1例．日口外誌 57: 284-288, 2011. – reference: 13) 山口素子：EBウイルスとリンパ網内系疾患；NK細胞リンパ腫．血腫瘍 56: 306-313, 2008. – reference: 20) Lee J, Suh C, et al : Extranodal natural killer-T cell lymphoma, nasal type; a prognostic model from a retrospective multicenter study. J Clin Oncol 24: 612-618, 2006. – reference: 21) Suzuki R, Takeuchi K, et al : Extranodal NK/T-cell lymphoma: diagnosis and treatment cues. Hematol Oncol. 26: 66-72, 2008. – reference: 19) 磯辺康司：NK/T細胞リンパ腫．Pharma Media 24: 145-148, 2006. – reference: 23) Yamaguchi M, Tobinai K, et al : Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: Japan Clinical Oncology Group Study JCOG0211. J Clin Oncol 20; 27: 5594-5600, 2009. – reference: 5) 占部一彦，古郷幹彦，他：長期間再発性潰瘍の症状を呈した特異なNK/T細胞リンパ腫の1例．阪大歯学誌 46: 91-95, 2002. – reference: 12) 神津由直，山本亞有美，他：初期臨床像を観察し得た口蓋歯肉原発節外性NK/T細胞リンパ腫，鼻型の1例．日口外誌 57: 610-614, 2011. – reference: 18) 青笹克之，菅野祐幸，他：鼻腔NK細胞リンパ腫の病理・疫学．血腫瘍 40: 91-92, 2000. – reference: 16) 形浦昭克，原渕保明：進行性鼻壊疽 (鼻性T細胞リンパ腫) の本態と臨床．耳展 38: 541-565, 1995. – reference: 4) 田畑雅彦，吉田 稔，他：歯肉への浸潤を初発症状としたNK細胞由来と考えられる悪性リンパ腫．癌の臨床 43: 968-972, 1997. – reference: 6) 水柿雄三，早津良和，他：口蓋に発生した進行性鼻壊疽（T/NK細胞リンパ腫) の1例．日口外誌 48: 394-397, 2002. – reference: 2) Oshimi K, Kawa K, et al : NK-cell neoplasm in Japan. Hematol 10: 237-245, 2005. – reference: 17) 鈴木淳司，田村和夫，他：NK細胞リンパ腫の臨床病態．血腫瘍 42: 319-324, 2001． |
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| Title | 口蓋粘膜原発の節外性NK/T細胞リンパ腫, 鼻型の1例 |
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