Extranodal NK/T-cell Lymphoma Mimicking Granulomatous Myositis
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- Kawaguchi Norihiko
- Department of Neurology, Tohoku Medical and Pharmaceutical University, Japan
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- Izumi Rumiko
- Department of Neurology, Tohoku University School of Medicine, Japan
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- Kobayashi Masahiro
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Japan
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- Tateyama Maki
- Department of Neurology, Tohoku University School of Medicine, Japan Department of Neurology, Iwate National Hospital, Japan
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- Suzuki Naoki
- Department of Neurology, Tohoku University School of Medicine, Japan
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- Fujishima Fumiyoshi
- Department of Pathology, Tohoku University Hospital, Japan
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- Fujimori Juichi
- Department of Neurology, Tohoku Medical and Pharmaceutical University, Japan
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- Aoki Masashi
- Department of Neurology, Tohoku University School of Medicine, Japan
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- Nakashima Ichiro
- Department of Neurology, Tohoku Medical and Pharmaceutical University, Japan
Abstract
<p>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. </p>
Journal
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- Internal Medicine
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Internal Medicine 58 (2), 277-282, 2019-01-15
The Japanese Society of Internal Medicine