Abstract
A47-year-old man was admitted to Showa University Fujigaoka Hospital in January 1998, with complaints of fever, abdominal pain and pleural effusion. The chest X-ray revealed hazy inf iltrative shadows in both the lower lung fields, and an upper gastrointestinal (GI) endoscopical examination disclosed a mass located in the duodenum. A malignant lymphoma, non-Hodgkin, angiocentric type was suggested by the microscopic examination of the hematoxylin-eosin (HE) staining materials prepared from the transbronchial lung biopsy (TBLB ) specimens. Immunohistochemically, malignant cells were positive for CD3, CD8, CD56, as well as for the cytotoxic cell-associated molecules such as granzyme B and TIA-1. A cytoloxic examination of the pleural effusion indicated that malignant cells morphologically resembled large granular lymphocytes, and molecular biological analysis revealed that the T cell receptor (TCR) β gene of these cells was rearrenged. On the basis of these findings, we reached the conclusion that this case represented natural killer-like (NK-like) T cell lymphoma. The patient was initially treated with chemotherapy but died about three months after the diagnosis was made. Autopsy findings suggested that the primary focus of the NK/T cell lymphoma was the Duodenum.
