Intestinal natural killer/T-cell lymphoma presenting as a pancreatic head space-occupying lesion:A case report  

作　　者：Ya-Nan Wang Yi-Miao Zhu Xiao-Ju Lei Yuan Chen Wan-Mao Ni Zheng-Wei Fu Wen-Sheng Pan 

机构地区：[1]College of Biotechnology and Bioengineering,Zhejiang University of Technology,Hangzhou 310032,Zhejiang Province,China [2]Department of Gastroenterology,Zhejiang Provincial People’s Hospital,People’s Hospital of Hangzhou Medical College,Hangzhou 310014,Zhejiang Province,China [3]Department of Endoscopy Center,Zhejiang Provincial People’s Hospital,People’s Hospital of Hangzhou Medical College,Hangzhou 310014,Zhejiang Province,China [4]Department of Pathology,Zhejiang Provincial People’s Hospital,People’s Hospital of Hangzhou Medical College,Hangzhou 310014,Zhejiang Province,China [5]Cancer Center,Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province,Zhejiang Provincial People’s Hospital,Hangzhou Medical College,Hangzhou 310014,Zhejiang Province,China [6]Molecular Diagnosis Laboratory,Zhejiang Provincial People's Hospital,People's Hospital of Hangzhou Medical College,Hangzhou 310014,Zhejiang Province,China

出　　处：《World Journal of Gastrointestinal Oncology》2023年第1期195-204,共10页世界胃肠肿瘤学杂志（英文版）（电子版）

基　　金：Supported by the Major Science and Technology Project of Zhejiang Provincial Department of Science and Technology,No.2020C03030;the Foundation of Zhejiang Educational Committee,No.Y202146136.

摘　　要：BACKGROUND Intestinal natural killer/T-cell lymphoma(NKTCL)is a rare and aggressive non-Hodgkin’s lymphoma,and its occurrence is closely related to Epstein-Barr virus infection.In addition,the clinical symptoms of NKTCL are not obvious,and the specific pathogenesis is still uncertain.While NKTCL may occur in any segment of the intestinal tract,its distinct location in the periampullary region,which leads clinicians to consider mimics of a pancreatic head mass,should also be addressed.Therefore,there remain huge challenges in the diagnosis and treatment of intestinal NKTCL.CASE SUMMARY In this case,we introduce a male who presented to the clinic with edema of both lower limbs,accompanied by diarrhea,and abdominal pain.Endoscopic ultrasound(EUS)showed well-defined homogeneous hypoechoic lesions with abundant blood flow signals and compression signs in the head of the pancreas.Under the guidance of EUS-fine needle biopsy(FNB)with 19 gauge or 22 gauge needles,combined with multicolor flow cytometry immunophenotyping(MFCI)helped us diagnose NKTCL.During treatments,the patient was prescribed the steroid(dexamethasone),methotrexate,ifosfamide,L-asparaginase,and etoposide chemotherapy regimen.Unfortunately,he died of leukopenia and severe septic shock in a local hospital.CONCLUSION Clinicians should enhance their understanding of NKTCL.Some key factors,including EUS characteristics,the right choice of FNB needle,and combination with MFCI,are crucial for improving the diagnostic rate and reducing the misdiagnosis rate.

关 键 词：Intestinal natural killer/T-cell lymphoma Endoscopic ultrasound-guided fine-needle biopsy Multicolor flow cytometry immunophenotyping Diagnosis Case report 

分 类 号：R735.35[医药卫生—肿瘤]