© 2005 BMJ Publishing Group Ltd & Association of Clinical Pathologists
CASE REPORT
Diagnostic cues for natural killer cell lymphoma: primary nodal presentation and the role of in situ hybridisation for Epstein-Barr virus encoded early small RNA in detecting occult bone marrow involvement
1 University Department of Medicine, Queen Mary Hospital, Pokfulam Road, Hong Kong, China
2 University Department of Pathology, Queen Mary Hospital
Correspondence to:
Correspondence to:
Dr Y L Kwong
University Department of Medicine, Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong, China; ylkwong{at}hkucc.hku.hk
Natural killer (NK) cell lymphomas are rare, and atypical features might lead to diagnostic pitfalls. This report describes an unusual patient in whom lymphoma occurred initially as isolated lymph node involvement, an exceptional presentation of an almost exclusively extranodal disease. Furthermore, during the terminal haemophagocytosis in the bone marrow, lymphoma cells lost the expression of the NK cell marker, CD56, making the histopathological diagnosis of bone marrow involvement difficult. This was resolved by in situ hybridisation for Epstein-Barr virus encoded small RNA, which detected occult bone marrow infiltration.
Abbreviations: EBER, Epstein-Barr virus encoded early small RNA; EBV, Epstein-Barr virus; ISH, in situ hybridisation; NK, natural killer
Keywords: CD56; Epstein-Barr virus encoded early small RNA; natural killer cell lymphoma; nodal
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