Extranodal NK/T cell lymphoma, nasal type, of the small intestine diagnosed by double-balloon endoscopy

Shihoko Wakabayashi; Ayako Arai; Gaku Oshikawa; Akihiro Araki; Mamoru Watanabe; Naoyuki Uchida; Shuichi Taniguchi; Osamu Miura

doi:10.1007/s12185-009-0438-7

Extranodal NK/T cell lymphoma, nasal type, of the small intestine diagnosed by double-balloon endoscopy

Int J Hematol. 2009 Dec;90(5):605-610. doi: 10.1007/s12185-009-0438-7. Epub 2009 Nov 20.

Authors

Shihoko Wakabayashi¹, Ayako Arai², Gaku Oshikawa¹, Akihiro Araki³, Mamoru Watanabe³, Naoyuki Uchida⁴, Shuichi Taniguchi⁴, Osamu Miura¹

Affiliations

¹ Department of Hematology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
² Department of Hematology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. ara.hema@tmd.ac.jp.
³ Department of Gastroenterology and Hepatology, Graduate School of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
⁴ Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.

PMID: 19936878
DOI: 10.1007/s12185-009-0438-7

Abstract

Extranodal NK/T-cell lymphoma (ENKL), nasal type, is rare and the small intestine is quite extraordinary as a primary lesion site. We report a 47-year-old man with ENKL of the small intestine. He was referred to our hospital because of bloody stool and the diagnosis was made by double-balloon endoscopy (DBE) of the small intestine without surgical procedure. His clinical stage was IVB and he was categorized in group 4 by prognostic index of ENKL. He went into complete remission (CR) after intensive chemotherapy (DeVIC) and subsequently underwent allogeneic bone marrow transplantation (BMT). Although he remained in CR for about 8 months after BMT, he died of disease recurrence 14 months after the diagnosis was made. ENKL of the small intestine follows a highly aggressive course. We describe the usefulness of DBE for diagnosis and management for ENKL of the small intestine. Additional cases, however, should be accumulated to establish optimal treatment strategy.

Publication types

Case Reports

MeSH terms

Combined Modality Therapy
Endoscopy, Gastrointestinal / methods*
Fatal Outcome
Humans
Intestinal Neoplasms / diagnosis*
Intestinal Neoplasms / therapy
Intestine, Small / pathology
Lymphoma, Extranodal NK-T-Cell / diagnosis*
Lymphoma, Extranodal NK-T-Cell / therapy
Male
Middle Aged
Nose Neoplasms