Primary gastric natural killer/T-cell lymphoma with diffuse CD30 expression and without CD56 expression: A case report

Abstract

The majority of natural killer (NK)/T-cell lymphomas occur in the nasal cavity and rarely involve the stomach. They possess a specific immunophenotype, with the expression of cluster of differentiation (CD)56, CD2 and CD3ε, but without CD3 expression. Few cases of NK/T-cell lymphoma have partial CD30 expression. The present study reveals a unique case of a 41-year-old female patient with gastric NK/T-cell lymphoma that did not express CD56 and diffusely expressed CD30. Immunohistochemical staining demonstrated that the tumor cells expressed CD3ε, CD43, CD30 and granzyme B and did not express CD2, CD4, CD5, CD7, CD8, CD56, anaplastic lymphoma kinase, CD20, paired box-5 or pan cytokeratin. Based on the immunostaining profile and morphological features, the initial diagnosis considered was gastric anaplastic large cell lymphoma. However, following a consultation with other pathologists, the Epstein-Barr virus (EBV) status of the patient was investigated to exclude a diagnosis of NK/T-cell lymphoma. Notably, the signal for EBV RNA was diffuse positive. Therefore, the final diagnosis was corrected to NK/T-cell lymphoma. To the best of our knowledge, the present study is the first to report NK/T-cell lymphoma in the stomach with a diffuse CD30-positive and CD56-negative phenotype.

Gastric CD56-negative Extranodal Natural Killer/T-cell Lymphoma: A Case Report

“…To the best of the author's knowledge, only two cases of upper gastrointestinal CD56-negative ENKTCL-NT have been reported thus far. 14,15 Kim et al 14 reported a case of recurrence in the small intestine, particularly the duodenum, which was not a primary lesion like our case. Thus far, only Zhang et al 15 reported a primary gastric presentation, but they were not concerned with the clonal TCR gene and tumor cell lineage, unlike the present report.…”

“…14,15 Kim et al 14 reported a case of recurrence in the small intestine, particularly the duodenum, which was not a primary lesion like our case. Thus far, only Zhang et al 15 reported a primary gastric presentation, but they were not concerned with the clonal TCR gene and tumor cell lineage, unlike the present report. Moreover, considering available information regarding the typical immunophenotype of the tumor (i.e., CD56+) [4][5][6] and the reported rates of more than 70%, 4 the CD56−T-cell lineage in the present case is theoretically unique.…”

Primary central nervous system extranodal nasal‐type natural killer/T‐cell lymphoma with CD20 expression

“…Indeed, it has been reported that ENKTCL may show CD30-positive expression and CD56-negative expression. 27 The findings of the absence of ALK expression and presence of EBER expression do not favor a diagnosis of ALCL. Therefore, in our case, based on the histopathologic features and the expression of CD2, CD3ε, granzyme B, TIA-1 and EBER, a diagnosis of ENKTCL with CD20 expression was favored.…”

“…In addition, the tumor cells possessed the CD30 positive and CD56 negative phenotype in a younger patient, consequently leading to an initial diagnosis of anaplastic large cell lymphoma (ALCL). Indeed, it has been reported that ENKTCL may show CD30‐positive expression and CD56‐negative expression . The findings of the absence of ALK expression and presence of EBER expression do not favor a diagnosis of ALCL.…”

Integrated driver mutations profile of chinese gastrointestinal-natural killer/T-cell lymphoma

“…The prevalence of ENKTCL is highest in Asian and Latin American countries. Primary GI-NKTCL is extremely rare ( 1 – 3 ), with a limited number of reported cases and very few studies specifically focused on this subtype of NKTCL ( 34 – 37 ). Due to the rarity of the disease, the clinical, genomic and immune characteristics have not yet been clarified.…”