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The Korean Journal of Pathology 2007;41(4): 278-283.
Ki-1 Positive Extranodal NK/T Cell Lymphoma, Nasal Type, Mistaken as Dermatomyositis: A Case Report and Literature Review.
Hyun Jung Kim, Eunah Shin, Jung Yeon Kim, Kyeongmee Park, Young Jin Yoo, Seung Sook Lee
1Department of Pathology, Inje University, Sanggye Paik Hospital, Seoul. hjkim@sanggyepaik.ac.kr
2Department of Oncology, Inje University, Sanggye Paik Hospital, Seoul.
3Department of Pathology, Korea Cancer Center Hospital, Seoul, Korea.
We report a case of a 38-year-old male with extranodal NK/T-cell lymphoma, nasal type, showing unusual clinical and pathological features. The patient was admitted for soft tissue swelling and tenderness in both legs. The patient had been treated intermittently 8 months prior for repeated muco-cutaneous ulcers. A muscle biopsy showed medium-sized atypical lymphoid cells with bizarre nuclei and plump cytoplasm, infiltrating to the skeletal muscle fibers with angiocentricity. The immunoresults were Ki-1+, CD56+, cytoplasmic CD3+, with EBV-in situ hybridization +. The patient rapidly deteriorated and died of sepsis and respiratory failure shortly after initiation of low-dose chemotherapy. A careful review of previous biopsies revealed scarce atypical lymphoid cells around vessels with similar immunoprofiles without the presence of Ki-1 positive cells. This case emphasizes that an extranodal NK/T-cell lymphoma may have a dermatomyositis-like diffuse presentation. Ki-1 co-expression can be an unexpected event in a process of the disease course; however, this should be validated with future studies.
Key Words: Extranodal NK/T-cell lymphoma, nasal type; Dermatomyositis; Ki-1