Recurrent Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma with Meningeal Involvement
Extranodal natural killer/T-cell lymphoma nasal type (NNKTL) is a type of non-Hodgkin’s lymphoma that has been associated with Epstein–Barr virus (EBV). It has an aggressive behavior, known for predilection to metastasize to different organs. Central nervous system (CNS) spread from a primary locati...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2021/9972694 |
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| _version_ | 1832546091357175808 |
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| author | Sylvester Homsy Ralph Kamel Mark Raden Yevgeniy Skaradinskiy |
| author_facet | Sylvester Homsy Ralph Kamel Mark Raden Yevgeniy Skaradinskiy |
| author_sort | Sylvester Homsy |
| collection | DOAJ |
| description | Extranodal natural killer/T-cell lymphoma nasal type (NNKTL) is a type of non-Hodgkin’s lymphoma that has been associated with Epstein–Barr virus (EBV). It has an aggressive behavior, known for predilection to metastasize to different organs. Central nervous system (CNS) spread from a primary location has been reported. Different modalities of treatment such as chemotherapy and radiation therapy have been employed in the management of this disease. Severe toxicities of currently available treatment have made clinicians seek more targeted therapies using molecular profiling. We present a 44-year-old Hispanic patient who was diagnosed with an early-stage NNKTL and treated with the modified SMILE regimen for 6 cycles. His EBV DNA PCR turned undetectable and remained so throughout the treatment. He sustained complete right vision loss due to right optic nerve invasion by the tumor, leading to prophylactic intravitreal methotrexate to the contralateral eye. The patient achieved good response with minimal residual disease. He was supposed to start radiation as a sequential therapy. However, the acute development of severe headache and confusion lead to a complete workup showing leptomeningeal spread. He eventually succumbed to the disease. |
| format | Article |
| id | doaj-art-d7d9c8324e524d7b9e2cbe3ee338ab15 |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-d7d9c8324e524d7b9e2cbe3ee338ab152025-02-03T07:24:02ZengWileyCase Reports in Hematology2090-65602090-65792021-01-01202110.1155/2021/99726949972694Recurrent Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma with Meningeal InvolvementSylvester Homsy0Ralph Kamel1Mark Raden2Yevgeniy Skaradinskiy3Department of Internal Medicine, Staten Island University Hospital-Northwell Health, Staten Island, New York, NY, USADepartment of Internal Medicine, Staten Island University Hospital-Northwell Health, Staten Island, New York, NY, USADepartment of Radiology, Staten Island University Hospital-Northwell Health, Staten Island, New York, NY, USADivision of Hematology/Oncology, Staten Island University Hospital-Northwell Health, Staten Island, New York, NY, USAExtranodal natural killer/T-cell lymphoma nasal type (NNKTL) is a type of non-Hodgkin’s lymphoma that has been associated with Epstein–Barr virus (EBV). It has an aggressive behavior, known for predilection to metastasize to different organs. Central nervous system (CNS) spread from a primary location has been reported. Different modalities of treatment such as chemotherapy and radiation therapy have been employed in the management of this disease. Severe toxicities of currently available treatment have made clinicians seek more targeted therapies using molecular profiling. We present a 44-year-old Hispanic patient who was diagnosed with an early-stage NNKTL and treated with the modified SMILE regimen for 6 cycles. His EBV DNA PCR turned undetectable and remained so throughout the treatment. He sustained complete right vision loss due to right optic nerve invasion by the tumor, leading to prophylactic intravitreal methotrexate to the contralateral eye. The patient achieved good response with minimal residual disease. He was supposed to start radiation as a sequential therapy. However, the acute development of severe headache and confusion lead to a complete workup showing leptomeningeal spread. He eventually succumbed to the disease.http://dx.doi.org/10.1155/2021/9972694 |
| spellingShingle | Sylvester Homsy Ralph Kamel Mark Raden Yevgeniy Skaradinskiy Recurrent Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma with Meningeal Involvement Case Reports in Hematology |
| title | Recurrent Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma with Meningeal Involvement |
| title_full | Recurrent Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma with Meningeal Involvement |
| title_fullStr | Recurrent Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma with Meningeal Involvement |
| title_full_unstemmed | Recurrent Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma with Meningeal Involvement |
| title_short | Recurrent Nasal-Type Extranodal Natural Killer/T-Cell Lymphoma with Meningeal Involvement |
| title_sort | recurrent nasal type extranodal natural killer t cell lymphoma with meningeal involvement |
| url | http://dx.doi.org/10.1155/2021/9972694 |
| work_keys_str_mv | AT sylvesterhomsy recurrentnasaltypeextranodalnaturalkillertcelllymphomawithmeningealinvolvement AT ralphkamel recurrentnasaltypeextranodalnaturalkillertcelllymphomawithmeningealinvolvement AT markraden recurrentnasaltypeextranodalnaturalkillertcelllymphomawithmeningealinvolvement AT yevgeniyskaradinskiy recurrentnasaltypeextranodalnaturalkillertcelllymphomawithmeningealinvolvement |