Extranodal NK-T-cell lymphoma differential diagnosis: Difference between revisions

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==Overview==
==Overview==
Extranodal NK-T-cell lymphoma must be differentiated from other diseases such as [[anaplastic large cell lymphoma]], non specific inflammatory process, [[enteropathy associated T cell lymphoma]], and [[peripheral T cell lymphoma]].<ref name="Hindawi">Extranodal Natural-Killer/T-Cell Lymphoma, Nasal Type. Hindawi Publishing Corporation. http://www.hindawi.com/journals/ah/2010/627401/. Accessed on February 19, 2016 </ref>
Extranodal NK-T-cell lymphoma must be differentiated from other diseases such as [[NK cell lukemia]], [[lymphomatoid granulomatosis]], [[Diffuse large B cell lymphoma|EBV-positive diffuse large B cell lymphoma, NOS]], [[anaplastic large cell lymphoma]], non specific inflammatory process, [[enteropathy associated T cell lymphoma]], [[peripheral T cell lymphoma]], [[hepatosplenic T cell lymphoma]]


Extranodal NK/T-cell lymphoma, nasal type must be diffrentiated from [[Wegener's granulomatosis|Wegner's granulomatosis]], [[Polymorphic]] reticulosis, and Midline malignant [[Lymphomas|lymphoma]].<ref name="pmid58185232">{{cite journal| author=Kassel SH, Echevarria RA, Guzzo FP| title=Midline malignant reticulosis (so-called lethal midline granuloma). | journal=Cancer | year= 1969 | volume= 23 | issue= 4 | pages= 920-35 | pmid=5818523 | doi=10.1002/1097-0142(196904)23:4<920::aid-cncr2820230430>3.0.co;2-m | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5818523  }}</ref>
Extranodal NK/T-cell lymphoma, nasal type must be diffrentiated from [[Wegener's granulomatosis|Wegner's granulomatosis]], [[Polymorphic]] reticulosis, and Midline malignant [[Lymphomas|lymphoma]]
==Differential Diagnosis==
==Differential Diagnosis==
Extranodal NK-T-cell lymphoma must be differentiated from other diseases such as:<ref name="Hindawi">Extranodal Natural-Killer/T-Cell Lymphoma, Nasal Type. Hindawi Publishing Corporation. http://www.hindawi.com/journals/ah/2010/627401/. Accessed on February 19, 2016</ref>
*Extranodal NK t-cell must be differentiated with other NK and T cell hematologic malignancies and EBV-associated T cell or NK cell lymphoprolifrative disorders.<ref name="KarubeAoki2008">{{cite journal|last1=Karube|first1=Kennosuke|last2=Aoki|first2=Ryosuke|last3=Nomura|first3=Yuko|last4=Yamamoto|first4=Kohei|last5=Shimizu|first5=Kay|last6=Yoshida|first6=Shirou|last7=Komatani|first7=Hideki|last8=Sugita|first8=Yasuo|last9=Ohshima|first9=Koichi|title=Usefulness of flow cytometry for differential diagnosis of precursor and peripheral T-cell and NK-cell lymphomas: Analysis of 490 cases|journal=Pathology International|volume=58|issue=2|year=2008|pages=89–97|issn=13205463|doi=10.1111/j.1440-1827.2007.02195.x}}</ref>
* [[Anaplastic large cell lymphoma]] 
* Non specific inflammatory process
* [[Enteropathy associated T cell lymphoma]]
* [[Peripheral T cell lymphoma]]


Extranodal NK-T cell lymphoma, nasal type shows aggresive lethal midline granuloma macroscopicaly so it must be differentiated from diseases such as:<ref name="pmid5818523">{{cite journal| author=Kassel SH, Echevarria RA, Guzzo FP| title=Midline malignant reticulosis (so-called lethal midline granuloma). | journal=Cancer | year= 1969 | volume= 23 | issue= 4 | pages= 920-35 | pmid=5818523 | doi=10.1002/1097-0142(196904)23:4<920::aid-cncr2820230430>3.0.co;2-m | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5818523  }}</ref>
*Extranodal NK-T-cell lymphoma must be differentiated from other diseases such as:<ref name="Hindawi">Extranodal Natural-Killer/T-Cell Lymphoma, Nasal Type. Hindawi Publishing Corporation. http://www.hindawi.com/journals/ah/2010/627401/. Accessed on February 19, 2016 </ref><ref name="pmid58185232">{{cite journal| author=Kassel SH, Echevarria RA, Guzzo FP| title=Midline malignant reticulosis (so-called lethal midline granuloma). | journal=Cancer | year= 1969 | volume= 23 | issue= 4 | pages= 920-35 | pmid=5818523 | doi=10.1002/1097-0142(196904)23:4<920::aid-cncr2820230430>3.0.co;2-m | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5818523  }}</ref>
**[[NK cell lukemia]]
**[[Lymphomatoid granulomatosis]]
**[[Diffuse large B cell lymphoma|EBV-positive diffuse large B cell lymphoma, NOS]]
**[[Anaplastic large cell lymphoma]]
**Non specific inflammatory process
**[[Enteropathy associated T cell lymphoma]]
**[[Peripheral T cell lymphoma]]
**[[Hepatosplenic T cell lymphoma]]


* [[Wegener's granulomatosis|Wegner's granulomatosis]]
*Extranodal NK-T cell lymphoma, nasal type shows aggresive lethal midline granuloma macroscopicaly so it must be differentiated from diseases such as:<ref name="pmid5818523">{{cite journal| author=Kassel SH, Echevarria RA, Guzzo FP| title=Midline malignant reticulosis (so-called lethal midline granuloma). | journal=Cancer | year= 1969 | volume= 23 | issue= 4 | pages= 920-35 | pmid=5818523 | doi=10.1002/1097-0142(196904)23:4<920::aid-cncr2820230430>3.0.co;2-m | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5818523  }}</ref>
* [[Polymorphic]] reticulosis
**[[Wegener's granulomatosis|Wegner's granulomatosis]]
* Midline malignant [[Lymphomas|lymphoma]]
**[[Polymorphic]] reticulosis
**Midline malignant [[Lymphomas|lymphoma]]


{|
=== Differentiating extranodal NK T-cell  from other hematologic malignancies by immunophenotype and EBV infection: ===
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
Extranodal NK T-cell lymphoma express [[CD56]] on its surface accompanied with [[EBV]] infection.
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;|Diseases
{| style="border: 0px; font-size: 90%; margin: 3px; width:600px"
| colspan="6" rowspan="1"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Clinical manifestations'''
| valign="top" |
! colspan="7" rowspan="2"  style="background: #4479BA; color: #FFFFFF; text-align: center;|Para-clinical findings
|+
| colspan="1" rowspan="4"  style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Gold standard'''
'''Malignancies based on immunophenotype and EBV infection'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;|Additional findings
! style="background: #4479BA; width: 250px;" |{{fontcolor|#FFF|Disease}}
! style="background: #4479BA; width: 250px;" |{{fontcolor|#FFF|Immunophenotype}}
! style="background: #4479BA; width: 100px;" |{{fontcolor|#FFF|EBV}}
|-
|-
| colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|'''Symptoms'''
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |[[NK cell leukemia]]
! colspan="3" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical examination
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" |[[CD16]]+
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" | +
|-
|-
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab Findings
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |[[Lymphomatoid granulomatosis]]
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" |[[CD20]]+
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;|Histopathology
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" | +
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 1
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Symptom 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 1
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Physical exam 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 1
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Lab 3
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 1
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 2
! style="background: #4479BA; color: #FFFFFF; text-align: center;|Imaging 3
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |[[Diffuse large B cell lymphoma|EBV-positive diffuse large B cell lymphoma, NOS]]
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" |[[CD20]]+  [[CD76]]+
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |[[Peripheral T cell lymphoma|Peripheral T cell lymphoma, unspecified]]
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" |[[CD3 (immunology)|CD3]]+  [[CD56]]-
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |[[Anaplastic large cell lymphoma, ALK positive|Anaplastic large cell lymphoma]]
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" |[[CD30]]+
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Diseases
!Symptom 1
! colspan="1" rowspan="1" |Symptom 2
!Symptom 3
!Physical exam 1
! colspan="1" rowspan="1" |Physical exam 2
!Physical exam 3
!Lab 1
!Lab 2
!Lab 3
!Imaging 1
!Imaging 2
!Imaging 3
!Histopathology
|'''Gold standard'''
!Additional findings
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" align="center" |[[Hepatosplenic T cell lymphoma]]
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" |[[CD2]]+  [[CD70|CD7]]+  [[CD3 (immunology)|CD3]]+
| style="background: #F5F5F5; padding: 5px;" |
| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" | -
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 6
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|}
|}


==References==
==References==

Latest revision as of 15:25, 16 September 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2] Sowminya Arikapudi, M.B,B.S. [3]

Overview

Extranodal NK-T-cell lymphoma must be differentiated from other diseases such as NK cell lukemia, lymphomatoid granulomatosis, EBV-positive diffuse large B cell lymphoma, NOS, anaplastic large cell lymphoma, non specific inflammatory process, enteropathy associated T cell lymphoma, peripheral T cell lymphoma, hepatosplenic T cell lymphoma

Extranodal NK/T-cell lymphoma, nasal type must be diffrentiated from Wegner's granulomatosis, Polymorphic reticulosis, and Midline malignant lymphoma

Differential Diagnosis

  • Extranodal NK t-cell must be differentiated with other NK and T cell hematologic malignancies and EBV-associated T cell or NK cell lymphoprolifrative disorders.[1]
  • Extranodal NK-T cell lymphoma, nasal type shows aggresive lethal midline granuloma macroscopicaly so it must be differentiated from diseases such as:[4]

Differentiating extranodal NK T-cell from other hematologic malignancies by immunophenotype and EBV infection:

Extranodal NK T-cell lymphoma express CD56 on its surface accompanied with EBV infection.

Malignancies based on immunophenotype and EBV infection
Disease Immunophenotype EBV
NK cell leukemia CD16+ +
Lymphomatoid granulomatosis CD20+ +
EBV-positive diffuse large B cell lymphoma, NOS CD20+ CD76+ +
Peripheral T cell lymphoma, unspecified CD3+ CD56- -
Anaplastic large cell lymphoma CD30+ -
Hepatosplenic T cell lymphoma CD2+ CD7+ CD3+ -

References

  1. ↑ Karube, Kennosuke; Aoki, Ryosuke; Nomura, Yuko; Yamamoto, Kohei; Shimizu, Kay; Yoshida, Shirou; Komatani, Hideki; Sugita, Yasuo; Ohshima, Koichi (2008). "Usefulness of flow cytometry for differential diagnosis of precursor and peripheral T-cell and NK-cell lymphomas: Analysis of 490 cases". Pathology International. 58 (2): 89–97. doi:10.1111/j.1440-1827.2007.02195.x. ISSN 1320-5463.
  2. ↑ Extranodal Natural-Killer/T-Cell Lymphoma, Nasal Type. Hindawi Publishing Corporation. http://www.hindawi.com/journals/ah/2010/627401/. Accessed on February 19, 2016
  3. ↑ Kassel SH, Echevarria RA, Guzzo FP (1969). "Midline malignant reticulosis (so-called lethal midline granuloma)". Cancer. 23 (4): 920–35. doi:10.1002/1097-0142(196904)23:4<920::aid-cncr2820230430>3.0.co;2-m. PMID 5818523.
  4. ↑ Kassel SH, Echevarria RA, Guzzo FP (1969). "Midline malignant reticulosis (so-called lethal midline granuloma)". Cancer. 23 (4): 920–35. doi:10.1002/1097-0142(196904)23:4<920::aid-cncr2820230430>3.0.co;2-m. PMID 5818523.


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