Extranodal NK/T-cell lymphoma mimicking Crohn’s colitis

Wan Syahira Wan Ahmad Kammal, Isa Mohd Rose, Reena Rahayu Md Zin, Raja Affendi Raja Ali, Noraidah Masir

Research output: Contribution to journalArticle

Abstract

Introduction: Extranodal NK/T cell lymphoma is a rare tumour, typically involving the upper aerodigestive tract. Even rarer is primary extranasal disease involving the skin, testis, soft tissue and gastrointestinal tract. Case Report: We report a case of a 46-year-old Chinese male who presented with six months history of abdominal pain, weight loss and rectal bleeding. Diagnostic colonoscopy revealed multiple aphthous ulcers within the ileo-caecal region and distal transverse colon, separated by normal mucosa, mimicking skip lesions of Crohn’s colitis. Computer topography (CT) scan of the abdomen showed multiple circumferential thickenings involving predominantly the right colon. A clinical diagnosis of colonic Crohn’s disease with possible perforation was made. An extended right hemicolectomy was performed due to uncontrolled rectal bleeding. Histopathology examination of the colon showed infiltration by malignant lymphoid cells associated with necrosis, angiocentricity and angiodestruction. Immunohistochemical studies confirmed T-cell monoclonality, presence of cytotoxic granules and Epstein-Barr virus (EBV) infection. A diagnosis of extranodal NK/T cell lymphoma of the colon was made. Discussion: These findings highlight that colonic NK/T cell lymphoma may clinically mimic other benign inflammatory lesions and should be one of the differential diagnoses in patients presenting with gastrointestinal lesions. The final diagnosis is only possible with appropriate histological and immunohistochemical studies.

Original languageEnglish
Pages (from-to)195-199
Number of pages5
JournalMalaysian Journal of Pathology
Volume41
Issue number2
Publication statusPublished - Aug 2019
Externally publishedYes

Fingerprint

Extranodal NK-T-Cell Lymphoma
Colitis
Colon
Colonic Diseases
Hemorrhage
Aphthous Stomatitis
Transverse Colon
Epstein-Barr Virus Infections
T-Cell Lymphoma
Colonoscopy
Skin Diseases
Crohn Disease
Natural Killer Cells
Abdomen
Abdominal Pain
Gastrointestinal Tract
Testis
Weight Loss
Mucous Membrane
Differential Diagnosis

Keywords

  • Crohn’s colitis
  • EBV
  • Extranasal
  • Gastrointestinal lymphoma
  • NK/T cell lymphoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Cell Biology

Cite this

Extranodal NK/T-cell lymphoma mimicking Crohn’s colitis. / Wan Ahmad Kammal, Wan Syahira; Mohd Rose, Isa; Md Zin, Reena Rahayu; Raja Ali, Raja Affendi; Masir, Noraidah.

In: Malaysian Journal of Pathology, Vol. 41, No. 2, 08.2019, p. 195-199.

Research output: Contribution to journalArticle

@article{21e624321f2b43bfb06f1c64e4df3807,
title = "Extranodal NK/T-cell lymphoma mimicking Crohn’s colitis",
abstract = "Introduction: Extranodal NK/T cell lymphoma is a rare tumour, typically involving the upper aerodigestive tract. Even rarer is primary extranasal disease involving the skin, testis, soft tissue and gastrointestinal tract. Case Report: We report a case of a 46-year-old Chinese male who presented with six months history of abdominal pain, weight loss and rectal bleeding. Diagnostic colonoscopy revealed multiple aphthous ulcers within the ileo-caecal region and distal transverse colon, separated by normal mucosa, mimicking skip lesions of Crohn’s colitis. Computer topography (CT) scan of the abdomen showed multiple circumferential thickenings involving predominantly the right colon. A clinical diagnosis of colonic Crohn’s disease with possible perforation was made. An extended right hemicolectomy was performed due to uncontrolled rectal bleeding. Histopathology examination of the colon showed infiltration by malignant lymphoid cells associated with necrosis, angiocentricity and angiodestruction. Immunohistochemical studies confirmed T-cell monoclonality, presence of cytotoxic granules and Epstein-Barr virus (EBV) infection. A diagnosis of extranodal NK/T cell lymphoma of the colon was made. Discussion: These findings highlight that colonic NK/T cell lymphoma may clinically mimic other benign inflammatory lesions and should be one of the differential diagnoses in patients presenting with gastrointestinal lesions. The final diagnosis is only possible with appropriate histological and immunohistochemical studies.",
keywords = "Crohn’s colitis, EBV, Extranasal, Gastrointestinal lymphoma, NK/T cell lymphoma",
author = "{Wan Ahmad Kammal}, {Wan Syahira} and {Mohd Rose}, Isa and {Md Zin}, {Reena Rahayu} and {Raja Ali}, {Raja Affendi} and Noraidah Masir",
year = "2019",
month = "8",
language = "English",
volume = "41",
pages = "195--199",
journal = "Malaysian Journal of Pathology",
issn = "0126-8635",
publisher = "Malaysian Society of Pathologists",
number = "2",

}

TY - JOUR

T1 - Extranodal NK/T-cell lymphoma mimicking Crohn’s colitis

AU - Wan Ahmad Kammal, Wan Syahira

AU - Mohd Rose, Isa

AU - Md Zin, Reena Rahayu

AU - Raja Ali, Raja Affendi

AU - Masir, Noraidah

PY - 2019/8

Y1 - 2019/8

N2 - Introduction: Extranodal NK/T cell lymphoma is a rare tumour, typically involving the upper aerodigestive tract. Even rarer is primary extranasal disease involving the skin, testis, soft tissue and gastrointestinal tract. Case Report: We report a case of a 46-year-old Chinese male who presented with six months history of abdominal pain, weight loss and rectal bleeding. Diagnostic colonoscopy revealed multiple aphthous ulcers within the ileo-caecal region and distal transverse colon, separated by normal mucosa, mimicking skip lesions of Crohn’s colitis. Computer topography (CT) scan of the abdomen showed multiple circumferential thickenings involving predominantly the right colon. A clinical diagnosis of colonic Crohn’s disease with possible perforation was made. An extended right hemicolectomy was performed due to uncontrolled rectal bleeding. Histopathology examination of the colon showed infiltration by malignant lymphoid cells associated with necrosis, angiocentricity and angiodestruction. Immunohistochemical studies confirmed T-cell monoclonality, presence of cytotoxic granules and Epstein-Barr virus (EBV) infection. A diagnosis of extranodal NK/T cell lymphoma of the colon was made. Discussion: These findings highlight that colonic NK/T cell lymphoma may clinically mimic other benign inflammatory lesions and should be one of the differential diagnoses in patients presenting with gastrointestinal lesions. The final diagnosis is only possible with appropriate histological and immunohistochemical studies.

AB - Introduction: Extranodal NK/T cell lymphoma is a rare tumour, typically involving the upper aerodigestive tract. Even rarer is primary extranasal disease involving the skin, testis, soft tissue and gastrointestinal tract. Case Report: We report a case of a 46-year-old Chinese male who presented with six months history of abdominal pain, weight loss and rectal bleeding. Diagnostic colonoscopy revealed multiple aphthous ulcers within the ileo-caecal region and distal transverse colon, separated by normal mucosa, mimicking skip lesions of Crohn’s colitis. Computer topography (CT) scan of the abdomen showed multiple circumferential thickenings involving predominantly the right colon. A clinical diagnosis of colonic Crohn’s disease with possible perforation was made. An extended right hemicolectomy was performed due to uncontrolled rectal bleeding. Histopathology examination of the colon showed infiltration by malignant lymphoid cells associated with necrosis, angiocentricity and angiodestruction. Immunohistochemical studies confirmed T-cell monoclonality, presence of cytotoxic granules and Epstein-Barr virus (EBV) infection. A diagnosis of extranodal NK/T cell lymphoma of the colon was made. Discussion: These findings highlight that colonic NK/T cell lymphoma may clinically mimic other benign inflammatory lesions and should be one of the differential diagnoses in patients presenting with gastrointestinal lesions. The final diagnosis is only possible with appropriate histological and immunohistochemical studies.

KW - Crohn’s colitis

KW - EBV

KW - Extranasal

KW - Gastrointestinal lymphoma

KW - NK/T cell lymphoma

UR - http://www.scopus.com/inward/record.url?scp=85071455539&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071455539&partnerID=8YFLogxK

M3 - Article

C2 - 31427556

AN - SCOPUS:85071455539

VL - 41

SP - 195

EP - 199

JO - Malaysian Journal of Pathology

JF - Malaysian Journal of Pathology

SN - 0126-8635

IS - 2

ER -