Extranodal NK-T-cell lymphoma diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Diagnostic Study of Choice

Study of choice

Investigations:

  • Pathological examination of frozen section specimen may be misled the NK/T cell diagnosis.[1]
  • Circulating cell free EBV DNA levels by RT-PCR is a diagnostic factor for EBV assosiated malignancies[2], Like extranodal/NK T cell lymphoma.[3]
  • Measuring both Bam HI W DNA and LMP1 DNA is more useful as a prognosis predictor, these DNAs will decrease with treatment and increase with relapse.[4]
  • Recently, determination of negative immune checkpoints are considered as a drug target[5],in the case of extranodal NK/T cell lymphoma, PD-L1 will be expressed in the tumor, and patients with higher concenteration of soluble PD-L1 showed worse prognosis.[6]


Diagnostic results

The accompaniment of following findings on performing immunophenotyping on frozen section specimen and RT-PCR are confirmatory for Extranodal NK/T cell lymphoma:

  • Detection of CD56 and EBER1 on tumor cells[7]
  • EBV DNA (RT-PCR)[2]
Sequence of Diagnostic Studies

The [name of investigation] must be performed when:

  • The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
  • A positive [test] is detected in the patient, to confirm the diagnosis.

OR

The various investigations must be performed in the following order:

  • [Initial investigation]
  • [2nd investigation]

Name of Diagnostic Criteria

It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.

[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].

OR

There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].

OR

The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].

OR

The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].

OR

[Disease name] may be diagnosed at any time if one or more of the following criteria are met:

  • Criteria 1
  • Criteria 2
  • Criteria 3

OR

IF there are clear, established diagnostic criteria

The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].

OR

The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].

OR

The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].

OR

IF there are no established diagnostic criteria

There are no established criteria for the diagnosis of [disease name].

References

  1. Harabuchi, Yasuaki; Takahara, Miki; Kishibe, Kan; Nagato, Toshihiro; Kumai, Takumi (2019). "Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type: Basic Science and Clinical Progress". Frontiers in Pediatrics. 7. doi:10.3389/fped.2019.00141. ISSN 2296-2360.
  2. 2.0 2.1 Harabuchi, Yasuaki; Imai, Shosuke; Wakashima, Junichi; Hirao, Motoyasu; Kataura, Akikatsu; Osato, Toyoro; Kon, Shinichiro (1996). "Nasal T-cell lymphoma causally associated with Epstein-Barr virus: Clinicopathologic, phenotypic, and genotypic studies". Cancer. 77 (10): 2137–2149. doi:10.1002/(SICI)1097-0142(19960515)77:10<2137::AID-CNCR27>3.0.CO;2-V. ISSN 0008-543X.
  3. Lei, Kenny I. K.; Chan, Lisa Y.S.; Chan, Wing Y.; Johnson, Philip J.; Lo, Y. M. Dennis (2000). "Quantitative analysis of circulating cell-free Epstein-Barr virus (EBV) DNA levels in patients with EBV-associated lymphoid malignancies". British Journal of Haematology. 111 (1): 239–246. doi:10.1046/j.1365-2141.2000.02344.x. ISSN 0007-1048.
  4. Ishii, Hideyuki; Ogino, Takeshi; Berger, Christoph; Köchli-Schmitz, Nicole; Nagato, Toshihiro; Takahara, Miki; Nadal, David; Harabuchi, Yasuaki (2007). "Clinical usefulness of serum EBV DNA levels of BamHI W and LMP1 for Nasal NK/T-cell lymphoma". Journal of Medical Virology. 79 (5): 562–572. doi:10.1002/jmv.20853. ISSN 0146-6615.
  5. Taube, J. M.; Klein, A.; Brahmer, J. R.; Xu, H.; Pan, X.; Kim, J. H.; Chen, L.; Pardoll, D. M.; Topalian, S. L.; Anders, R. A. (2014). "Association of PD-1, PD-1 Ligands, and Other Features of the Tumor Immune Microenvironment with Response to Anti-PD-1 Therapy". Clinical Cancer Research. 20 (19): 5064–5074. doi:10.1158/1078-0432.CCR-13-3271. ISSN 1078-0432.
  6. Nagato, Toshihiro; Ohkuri, Takayuki; Ohara, Kenzo; Hirata, Yui; Kishibe, Kan; Komabayashi, Yuki; Ueda, Seigo; Takahara, Miki; Kumai, Takumi; Ishibashi, Kei; Kosaka, Akemi; Aoki, Naoko; Oikawa, Kensuke; Uno, Yuji; Akiyama, Naoko; Sado, Masatoshi; Takei, Hidehiro; Celis, Esteban; Harabuchi, Yasuaki; Kobayashi, Hiroya (2017). "Programmed death-ligand 1 and its soluble form are highly expressed in nasal natural killer/T-cell lymphoma: a potential rationale for immunotherapy". Cancer Immunology, Immunotherapy. 66 (7): 877–890. doi:10.1007/s00262-017-1987-x. ISSN 0340-7004.
  7. Harabuchi, Yasuaki; Takahara, Miki; Kishibe, Kan; Moriai, Shigetaka; Nagato, Toshihiro; Ishii, Hideyuki (2009). "Nasal natural killer (NK)/T-cell lymphoma: clinical, histological, virological, and genetic features". International Journal of Clinical Oncology. 14 (3): 181–190. doi:10.1007/s10147-009-0882-7. ISSN 1341-9625.

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