scholarly journals Chemorefractory extranodal nasal-type natural-killer/T-cell lymphoma with great response to pembrolizumab in a young patient: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Fatemeh Adabifirouzjaei ◽  
Bharam Khazai ◽  
Ghazaleh Azami ◽  
Ghazaleh Shoja-e-Razavi

Abstract Introduction Extranodal, natural-killer/T-cell lymphoma of nasal type is a rare but aggressive disease usually presenting as progressive necrotic lesions in the nasal cavity that responds poorly to chemotherapy. In this paper, we report a relapsing, chemorefractory case of extranodal natural-killer/T-cell lymphoma responding to checkpoint inhibitor immunotherapy with pembrolizumab. Case presentation A 32-year-old Hispanic woman with a history of recurrent sinusitis and preseptal abscess presented with a hoarse voice, swelling around the right eye, and diplopia. Laryngoscopy showed infiltrating tissue extending to bilateral laryngeal ventricles and false vocal cords. On immunohistochemical examination of laryngeal biopsy, the neoplastic cells showed positivity for CD3 (cytoplasmic), CD7, CD56, granzyme B, CD30, and Epstein–Barr virus-encoded ribonucleic acid (RNA). Extranodal natural-killer/T-cell lymphoma, nasal type, was confirmed. In the absence of distant organ involvement, the decision was to perform chemotherapy with etoposide, ifosfamide, mesna, cisplatin, and dexamethasone (VIPD protocol) followed by concurrent chemoradiation with weekly doses of cisplatin and two cycles of VIPD as adjuvant treatment. However, 1 month after completion of the treatment; disease recurrence was demonstrated. The patient was scheduled to receive salvage chemotherapy with steroid, methotrexate, ifosfamide, L- asparaginase, and etoposide (SMILE) protocol and CD30-targeting monoclonal antibodies. However, the mass was chemorefractory without response to either l-asparaginase-based salvage chemotherapy in combination with high-dose methotrexate or brentuximab vedotin. However, this case of chemorefractory extranodal natural-killer/T-cell lymphoma, nasal type, responded well to the novel drug pembrolizumab, which was able to control the disease. Conclusion Checkpoint inhibitors are potential treatment option in selected chemorefractory extranodal natural-killer/T-cell lymphoma, nasal type, cases.

2021 ◽  
pp. 014556132098764
Author(s):  
Anthony N. Eze ◽  
Adedoyin O. Kalejaiye

Extranodal natural killer (NK)/T-cell lymphoma, nasal type (NNKTL) is a rare and highly aggressive non-Hodgkin lymphoma originating from NK or γδ T cells infected by Epstein-Barr virus (EBV). In the United States, NNKTL is usually noted in people of Asian or Hispanic descent. Natural killer/T-cell lymphoma, nasal type commonly involves the upper aerodigestive tract, including the nasopharynx, nasal cavity, Waldeyer’s ring, and oropharynx. Extensive local destruction and invasion has been noted, especially of the paranasal sinuses, hard palate, and central nervous system; involvement of the nasolacrimal duct with dacryocystitis is yet to be reported. We report a rare case of a Hispanic man with extranodal NNKTL masquerading as persistent dacryocystitis and necrotizing sinusitis unresponsive to antibiotics and surgical intervention. An extensive background of necrosis and inflammation was noted on pathology, and additional analysis with immunohistochemistry and in situ hybridization after repeat biopsy were necessary for accurate diagnosis.


2016 ◽  
Vol 12 (2) ◽  
pp. 825-836 ◽  
Author(s):  
Hua Wang ◽  
Pengfei Li ◽  
Xinke Zhang ◽  
Zhongjun Xia ◽  
Yue Lu ◽  
...  

2019 ◽  
Vol 43 (7) ◽  
pp. 995-1004
Author(s):  
Chun-xiang Xiang ◽  
Zi-hang Chen ◽  
Sha Zhao ◽  
Li-min Gao ◽  
Qing Tao ◽  
...  

2010 ◽  
Vol 28 (6) ◽  
pp. e94-e95 ◽  
Author(s):  
Laura B. Pincus ◽  
James L. Zehnder ◽  
Isaac M. Neuhaus ◽  
Charalambos Andreadis ◽  
Timothy H. McCalmont

2009 ◽  
Vol 102 (8) ◽  
pp. 873-874
Author(s):  
Rawan G. Abu-Zeitoon ◽  
Fadi Abu-Shahin ◽  
Roger D. Smalligan ◽  
Agnes Hamati

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