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

• Published in: 日本口腔外科学会雑誌 Vol. 57; no. 11; pp. 610 - 614
• Main Authors: 丹沢, 秀樹, 小池, 博文, 鵜澤, 一弘, 神津, 由直, 山本, 亞有美, 椎葉, 正史
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.11.2011
• Subjects: EBウイルス; 口蓋歯肉; 壊死性潰瘍; 節外性NK/T細胞リンパ腫−鼻型; 紫斑様病変
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.57.610

Extranodal natural killer/T-cell lymphoma, nasal type (ENKL) characterized by a necrotizing ulcer is an uncommon malignant lymphoma thought to be associated with Epstein-Barr virus infection and expression of CD56. We report a case of ENKL that could be observed from the earliest clinical features of the palatal gingiva. A 27-year-old-woman was referred to our hospital because of painful purpura-like lesions in the left side of the palatal gingiva. The purpura-like lesions developed to a necrotizing ulcer in about 1 week. Microscopic examination of a biopsy specimen demonstrated a lymphocytic infiltrate with increasingly atypical histopathological features. The atypical cells were positive for cytoplasmic CD3ε, granzyme B, and EBER-ISH, but negative for CD20 and CD56. Based on the histopathological findings, a final diagnosis of ENKL was made. The patient received radiotherapy to a dose of 50 Gy and three courses of DeVIC (CBDCA, VP-16, IFO, DEX) chemotherapy. There has been no sign of recurrence for 32 months after treatment. This case shows that purpura-like lesions might be one of the earliest clinical features of ENKL.