CUTANEOUS PRESENTATION OF NASAL NASAL TYPE T/NK CELL LYMPHOMA - CLINICOPATHOLOGICAL FINDINGS OF 4 CASES/

Epstein-Barr virus (EBV)-associated T/natural killer (NK) cell lymphom a mainly shows nasal lesions, and has recently been shown to be associ ated with cutaneous T-cell lymphoma (CTCL). The detailed features of C TCL nasal metastasis have yet to be elucidated, We report clinicopatho logical findings for four cases of cutaneous T/NK cell lymphoma with m etastasis to the nose. The four patients presented progressive involve ment of nasal lesions of CTCL, an aggressive course and poor outcome, Their pathological and immunohistological findings were consistent wit h peripheral T/NK cell neoplasm and, in three of four cases, EBER-1 we re apparently detected in lymphoma cells by in situ hybridization, and two of four cases were also positive for TIA-1, The polymerase chain reaction (PCR) results showed the identical band from the skin and nas al lesions of the two patients, We also reviewed the cases of similar clinical course and attempted to elucidate clinical, pathological, imm unological and genotypic features, The 10 reported cutaneous T/NK cell lymphomas with nasal metastasis revealed a poor prognosis (nine of 10 died at 3-108 months). Six cases of nine showed a positive reaction t o EBV, and six cases revealed T-cell receptor beta or -gamma rearrange ment. These findings suggest that most cutaneous T/NK cell lymphoma wi th nasal metastasis are similar to nasal T-cell lymphoma associated wi th EBV infection. This type of cutaneous T/NK cell lymphoma likely to involve nasal lesions and skin cases seemed to have a poor prognosis.