Extranodal Natural Killer/T-cell Lymphoma in a Child with a Prior History of Nasal Trauma: a Case Report

  • Suha N. Aloosi Department of Oral and Maxillofacial Surgery, School of Medicine, Faculty of Dentistry, University of Sulaimany, Kurdistan Region, Iraq
  • Shakhawan M. Ali KBMS Trainee, Maxillofacial Department, Sulaimany Teaching Hospital, Sulaimany, Kurdistan Region, Iraq
  • Vian F. Mohammed Hiwa Hospital for Blood Disease and Cancer, Sulaimany, Kurdistan Region, Iraq
  • Payman Kh. Mahmud KBMS Trainee, Oral medicine Department, Sulaimany Teaching Hospital, Sulaimany, Kurdistan Region, Iraq
  • Hemin A. Hassan Histopathologist and Laboratory Manager, Hiwa Oncology Hospital, Sulaimany, Kurdistan Region, Iraq
Keywords: Case reports, Child, Face, Head and neck neoplasms, Lymphoma, non-Hodgkin

Abstract

Introduction: Facial lesions usually have a benign self-limited prognosis, but in rare cases they have a poor outcome. Extranodal natural killer/T-cell lymphoma (ENK/TCL) is a rare aggressive lesion presenting with a midline facial lesion that can easily be misdiagnosed. Diagnosis is often difficult and requires a thorough clinical examination and the use of immunohistochemistry for analysis of biopsies. Such malignancies affecting the head and neck area provide an interesting but difficult diagnosis. The purpose of this article is to report a severe case of ENK/TCL-nasal type in a boy with a previous history of nasal trauma. Case presentation: An 11-year-old boy was referred to the maxillofacial unit of Sulaimany Teaching Hospital, Iraq, with midline facial destruction. The patient stated that about 6 months prior he had fallen down and suffered nasal trauma; 3 months after the trauma, an asymptomatic ulcer appeared and gradually increased in size. Two biopsies were performed with no conclusive results. In the third biopsy, histology showed atypical lymphoid tissue surrounded by intense necrosis. The diagnosis was confirmed by immunohistochemistry. The treatment of choice was chemotherapy followed by radiotherapy. The patient had a satisfactory response but 2 months later during chemotherapy the patient unfortunately died from a pulmonary embolism. Conclusion: Suspicious midline ulcerative lesions in the head and neck region must have ENK/TCL considered in the differential diagnosis and repeated biopsies may be necessary to confirm the diagnosis.

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Published
2018-04-08
How to Cite
Aloosi, S., Ali, S., Mohammed, V., Mahmud, P., & Hassan, H. (2018). Extranodal Natural Killer/T-cell Lymphoma in a Child with a Prior History of Nasal Trauma: a Case Report. Advanced Journal of Emergency Medicine, 2(3), e34. https://doi.org/10.22114/ajem.v0i0.77
Section
Case (report / study)

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