Extranodal NK/ T-Cell lymphoma in an African

Abstract

Background: Extranodal Nasal NK (Natural Killer) / T-Cell lymphoma is one of the rare tumours of the head and neck region. Its prevalence is unknown among Africans. It is characterised by progressive destruction of the structures in the nasal cavity, may erode the palate and in some cases, it may metastasize. Hallmark of diagnosis is immunohistochemistry. With delayed presentation, the prognosis is very poor.

Methods: We present a 30 year old lady with complaints of two years' history of thick nasal discharge, progressive nasal blockage, hyponasal speech and pains in the nose. She was diagnosed with retroviral disease few weeks before presentation. Anterior rhinoscopy revealed a mass in the right nasal ala, destroyed nasal septum, crusts filling both nasal cavities. Patient had biopsy of the nasal mass and was screened for syphilis and Tuberculosis. She also had full blood count, serum electrolytes urea and creatinine assessment.

Results: Mantoux test and VDRL (Veneral Disease Research Laboratory) test were negative, histology result revealed malignant lymphoma and immunohistochemistry was positive for CD45, CD3, CD79a and Epstein-Barr virus-encoded RNA (EBER) but negative for CD10, CD20, EMA and Vimentin. By the time of making the diagnosis, the patient was lost to followup.

Conclusion: Extranodal NK/T-Cell lymphoma, being rarely seen among Africans, required high index of suspicion for diagnosis. Physicians should be on the lookout for it, multicentre reports should be collated to find its prevalence among Africans.

Keywords: African, NK / T-cell lymphoma, immunohistochemistry