Panhypopituitarism and cranial mononeuropathy, manifestation of NK/T lymphoma that imitates meningeal tuberculosis
Main Article Content
Keywords
Tuberculosis, Meningeal, Lymphoma Non-Hodgkin, Hypopituitarism
Abstract
Background: Lymphoma of NK/T cells (LNK/T) is a variety of non-Hodgkin lymphoma; the nasal type is the most common presentation. The aim of this article is to present a case of LNK/T with affection to central nervous system that imitates meningeal tuberculosis.
Case report: 31 years old man with nasal blockage feeling, headache, fever, panhypopituitarism and multiple cranial mononeuropathy, with a pituitary injury demonstrated by magnetic resonance image and meningeal thickening, that progress with pancytopenia and soft palate ulcer. The diagnosis was made by nasal concha biopsy compatible with lymphoma infiltration, of LNK/T cell linage.
Conclusions: The affectation of LNK/T cell lymphoma in central nervous system is a rare presentation. the diagnosis could be delayed for the presence of heterogeneous symptoms. Mycobacterium infection must be considered as a differential diagnosis in our population.
References
1. Taali L, Abou-Elfadl M, Fassih M, Mahtar M. Nasal NK /T cell lymphoma:a tragic case. Eur Ann Otorhinolaryngology Head Neck Dis. 2017;134(2):121-2. doi:10.1016/j.anorl.2016.08.006
2. Avilés A. Nasal NK/T-cell lymphoma. A comparative analysis of a Mexican population with the other populations of Latin-America. Mediterr J Hematol Infect Dis. 2015;7(1):e2015052. doi:10.4084/MJHID.2015.052
3. Kidwai SM, Parasher AK, Lin FY. An unusual presentation of NK/T-cell lymphoma, nasal-type in the United States. Am J Otorlaryngol. 2015;36(1):80-3. doi:10.1016/j.amjoto.2014.07.012
4. Zou H, Pan KH, Wu L, Pan HY, Ding YH, Zheng MH. Nasal NK/T cell lymphoma presents with long-term nasal blockage and fever:a rare case report and literature review. Oncotarget. 2016;7(8):9613-7. doi:10.18632/oncotarget.7386
5. Liu QF, Wang WH, Wang SL, Liu YP, Huang WT, Lu N, et al. Immunophenotypic and clinical differences between the nasal and extranasal subtipes of aerodigestive tract natural killer/T-cell lymphoma. Int J Radiat Oncol Biol Phys. 2014;88(4):806-13. doi:10.1016/j.ijrobp.2013.12.005
6. Al Shawabkeh MA, Al Sulaiti M, Al Sa'ey H, Ganesan S. Nasal type extranodal natural killer/T (NK/T) cell lymphoma presenting as periorbital cellulitis:a case report. Am J Case Rep. 2016;17:934-8. doi:10.12659/AJCR.899922
7. Luther N, Greenfield JP, Chadburn A, Schwartz TH. Intracraneal nasal natural killer/T-cell lymphoma:inmunopathologically-confirmed case and review of literature. J Neurooncology. 2005;75(2):185-8. doi:10.1007/s110060-005-1862z
8. Jabbari-Azad F, Delavarian Z, Hatami M, Rahimi H, Abdolvahed MR. Extranodal NK/T cell lymphoma with destruction of the uvulae:a case report. Iran J Otorhinolaryngol. 2017;29(91):101-8.
9. Kaluza V, Rao DS, Said JW, de Vos S. Primary extranodal nasal-type natural killer/T cell lymphoma of the brain:a case report. Hum Pathol. 2006;3(6):769-72. doi:10.1016/j.humpath.2006.01.032
10. Cai Q, Chen K, Young KH. Epstein-Barr virus-positive T/NK-cell lymphoproliferative disorders. Exp Mol Med. 2015;47:e133. doi:10.1038/emm.2014.105
11. Kierssling SY, Soyka MB, Huber GF, Holzmann D, Laske RD. Delayed diagnosis of sinonasal lymphoma due to bilateral manifestation. Eur Arch Otorhinolaryngol. 2017;274(2):823-7. doi:10.1007/s00405-016-4275-z
12. Pineda Galindo LF, Castro Castrezana L, Mora Campos MR, Pérez Torres A. Linfoma/leucemia agresiva de células NK primario de laringe:reporte de un caso y revisión de la literatura. Lab Acta. 2009;21(4):73-8.
13. Steele TO, Buniel MC, Mace JC, El Rassi E, Smith TL. Lymphoma of the nasal cavitiy and paranasal sinuses:a case series. Am J Rhinol Allergy. 2016;30(5):335-9. doi:10.2500/ajra.2016.30.4347
14. Celentano A, Mascolo M, Cirillo N, De Rosa G, Mignogna MD. Delayed diagnosis of a nasal type lymphoma misdiagnosed a persistent sinusitis. J Adolesc Young Adult Oncol. 2017;6(2):381-4. doi:10.1089/jayao.2016.0050
15. Liu JK, Samaya C, Chin SS, Couldwell WT. Extranodal NK/T-cell lymphoma presenting as a pituitary mass. Case report and review of the literature. J Neurosurg. 2007;107(3):660-5. doi:10.3171/JNS-07/09/0660
16. Guan H, Huang Y, Wen W, Xu M, Zan Q, Zhang Z. Primary central nervous system extranodal NK/T-cell lymphoma nasal type:case report a review of the literature. J Neurooncol. 2011;103(2):387-91. doi:10.1007/s11060-010-0384-5
17. Cai B, Hu JJ, Tang QX, Lin W, Wang N. Primary meningeal NK/T cell lymphoma masquerading as tuberculosis meningitis. Neurol Sci. 2014;35(9):1467-9. doi:10.1007/s10072-014-1783-8
18. Trabay A, Cossu G, Berhouma M, Levivier M, Daniel RT, Messerer M. Primary pituitary lymphoma:an update of the literature. J Neurooncol. 2016;130(3):383-95. doi:10.1007/s11060-016-2249-z
19. Doh K, Tagba E, Thiam I, Sarr A, Woto-Gaye G. NK/T-cell lymphoma of nasal-type:a rare affection with a poor prognosis. Rev Stomatol Chir Maxillofac Chir Orale. 2016;117(3):167-9. doi:DOI:10.1016/j.revsto.2016.02.001
20. Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J, editores. Harrison Principios de medicina interna. 19.a ed. Ciudad de México, México:McGraw-Hill Interamericana;2016.
21. Scott BJ, Douglas VC, Tihan T, Rubenstein JL, Josephson SA. A systematic approach to the diagnosis of suspected central nervous system lymphoma. JAMA Neurol. 2013;70(3):311-9. doi:10.1001/jamaneurol.2013.606
22. Asakura T, Ishii M, Kikuchi T, Kameyama K, Namkoong H, Nakata N, et al. Disseminate Mycobacterium marinum infection with a destructive nasal lesion mimicking extranodal NK/T cell lymphoma:a case report. Medicine (Balt). 2016;95(11):e3131. doi:10.1097/MD.00000000000031
23. Jetley S, Jairajpuri ZS, Pujani M, Khan S, Rana S. Tuberculosis “The Great Imitator“:a usual disease with unusual presentations. Indian J Tuberc. 2017;64(1):54-9. doi:10.1016/j.ijtb.2016.01.001
24. Vives-RicomàE, Guallar-Larpa M, Artal-Sánchez R, Galindo-Torres B, Llano-Espinosa M, Rebolledo-Bernad L, et al. Tuberculosis del seno maxilar con afectación hipofisaria. O.R.L. Aragon. 2016;19(2):16-7.
25. Srisukh S, Tanpaibule T, Kiertiburanakul S, Boongird A, Wattanatranon D, Panyaping T, et al. Pituitary tuberculoma:a consideration in the differential diagnosis a patient manifesting with pituitary apoplexy-like syndrome. IDCases. 2016;5:63-6. doi:10.1016/j.idcr.2016.07.012
26. Malik JN, Jan S, Monga S, Bahadur S. Sinonasal tuberculosis:report of three atypical cases. Indian J Tuberc. 2015;63(4):268-72. doi:10.1016/j.ijtb.2015.06.001
27. Mendoza-Álvarez SA, Rodríguez-Dávila FM, Moranchel-García L, Soto V, Quispe N. Linfoma T/NK nasal en granulomatosis con poliangeítis. Reporte de un caso. Rev Med Inst Mex Seguro Soc. 2017;55(3):394-8.
28. Jia J, Song Y, Lin N, Liu W, Ping L, Zheng W, et al. Clinical features and survival of extranodal natural killer/T cell lymphoma with and without hemophagocytic syndrome. Ann Hematol. 2016;95(12):2013-31. doi:10.1007/s00277-016-2805-9