Abstract
The case reported here is of a 37-year-old man who was admitted to the Department of Hematology at this hospital because of fever and general fatigue on December 28, 1998. Examination of this patient showed cytopenia, hepatosplenomegaly, hepatic dysfunction and a high serum level of lactate dehydrogenase (LDH) . Specimens obtained by bone marrow puncture and liver biopsy indicated that lymphoma cells had infiltrated both organs. The hematoxylin-eosin (HE) staining and immunohistochemical findings obtained from biopsy of the cervical lymph node revealed that this case was non-Hodgkin lymphoma and belonged to the peripheral T-cell and NK-cell neoplasms (WHO classification) . A NK cell lymphoma was suspected to be most likely amongst this group. Although chemotherapies such as CHOP, CHOP-E and E-POOH were performed, the patient had poor responses to these therapies and died on March 27, 1999, three months after admission. Since molecular biological analysis failed to detect the T-cell receptor (TCR) gene rearrangement of lymphoma cells obtained from the autopsy specimens, this case was finally diagnosed as NK cell lymphoma. This is a rare case because the primary foci of the NK cell lymphoma which expressed cytotoxic molecules such as granzyme B and T cell-restricted intercellular antigen (TIA-1) was suspected to be the spleen.
