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Nasal‐type natural killer cell lymphoma preceded by benign panniculitis arising in an asymptomatic HTLV‐1 carrier
Author(s) -
Kunisada M.,
Adachi A.,
Matsumoto S.,
Ogawa Y.,
Horikawa T.,
Iwatsuki K.
Publication year - 2003
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1046/j.1365-4362.2003.01757.x
Subject(s) - medicine , lymphoma , pathology , immunology , leukemia , panniculitis
We report a case of an Epstein‐Barr virus (EBV)‐associated nasal‐type natural killer cell lymphoma (NKCL) preceded by benign panniculitis, which arose in a 48‐year‐old woman with an asymptomatic human T‐cell leukemia/lymphoma virus type‐1 (HTLV‐1) infection. A biopsy of the initial panniculitis lesion demonstrated lobular panniculitis with a germinal center composed of benign mononuclear cells with a phenotype of CD4 + CD45RO + CD5sCD3 + cCD3ɛ + T‐cell intracellular antigen‐1 (TIA‐1) − and granzyme B − . One year after oral prednisolone therapy, the patient developed subcutaneous nodules composed of atypical lymphoid cells with a phenotype of CD4 − CD45RO + CD56 + sCD3 − cCD3ɛ + (TIA‐1) + and granzyme B + . In the initial panniculitis lesion, neither EBV‐encoded RNA (EBER‐1) nor clonal proliferation of EBV‐infected cells was identified. In later lesions, however, a large number of atypical cells were positive for EBER‐1, and a clonal expansion of EBV‐infected cells was detected. No clonal rearrangement of T‐cell receptor‐α, ‐β, or ‐γ genes was found in either specimen. This patient was an asymptomatic carrier of human T‐cell leukemia/lymphoma virus type‐1 (HTLV‐1) without clonal integration of proviral HTLV‐1 in neither the peripheral blood nor the skin lesions. These observations suggest that EBV‐associated NKCL occurred subsequently in the clinical course of benign panniculitis under the influence of immunosuppression caused by prednisolone treatment and HTLV‐1 infection.