nasal type

  • 文章类型: Journal Article
    背景:天冬氨酸氨基转移酶(AST),肝细胞损伤的指标,与某些恶性肿瘤的预后有关。
    目的:本研究检查了AST在结外自然杀伤/T细胞淋巴瘤(ENKTL)患者中的预测价值。
    方法:我们回顾了183例诊断为ENKTL的病例,并选择26U/L作为AST的最佳临界值。我们使用单变量和多变量Cox回归比较不同AST组的总生存期(OS)和无进展生存期(PFS)。
    结果:倾向得分匹配(PSM)之前,Kaplan-Meier分析显示,低AST亚组患者的OS和PFS优于高AST亚组。多因素分析显示AST是预后的独立指标。PSM之后,低AST亚组的OS和PFS明显优于高AST亚组。
    结论:AST可能代表ENKTL患者的重要预后指标。
    UNASSIGNED: Aspartate aminotransferase (AST), an indicator of liver cell damage, was related to the prognosis of certain malignant tumors.
    UNASSIGNED: This study examined the predictive value of AST in patients with extranodal natural killer/T cell lymphoma (ENKTL).
    UNASSIGNED: We reviewed 183 cases diagnosed with ENKTL and selected 26 U/L as the optimum cut-off value of AST. We used the univariate and multivariate Cox regression to compare the different AST groups\' overall survival (OS) and progression-free survival (PFS).
    UNASSIGNED: Prior to propensity score matching (PSM), Kaplan-Meier analysis showed that patients in the low AST subgroup had better OS and PFS than the high AST subgroup. Multivariate analysis revealed that AST was an independent indicator for prognosis. After PSM, the low AST subgroup maintained a significantly better OS and PFS than the high AST subgroup.
    UNASSIGNED: AST might represent a significant prognostic marker for ENKTL patients.
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  • Extranodal NK/T cell lymphoma, nasal type(ENKTL) is a highly aggressive malignant tumor derived from NK cells. This article reports a case of ENKTL invading the larynx and digestive tract. The clinical clinical manifestations include hoarseness and intranasal masses.
    摘要: 结外鼻型NK/T细胞淋巴瘤(extranodal NK/T cell lymphoma,nasal type,ENKTL)是NK细胞起源的高度侵袭性恶性肿瘤,本文报告1例侵及喉及消化道的ENKTL患者,临床表现为声音嘶哑、鼻腔内肿物。.
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  • 文章类型: Journal Article
    背景:目前,外周血标志物是结外鼻型自然杀伤/T细胞淋巴瘤(ENKTCL)的信息和有临床价值的预后指标.然而,其综合评分在ENKTCL中的作用尚待确定。
    目标:因此,本研究旨在探讨外周炎症评分对ENKTCL预后的影响。
    方法:回顾性研究纳入183例ENKTCL患者。使用单变量Cox回归分析和最小绝对收缩和选择算子(LASSO)Cox回归构建炎症相关的预后指标Risk。使用单因素和多因素Cox回归分析以及倾向评分匹配(PSM)回归校正来评估风险的预后能力。通过整合风险来评估修改的列线图修订的风险指数(NRI)的性能与时间依赖性受试者工作特征(ROC)曲线(AUC)下的面积,决策曲线分析(DCA),和综合Brier评分(IBS)。
    结果:风险截止值,由淋巴细胞计数构成,血小板计数,白蛋白水平,LMR,PNI,为-1.3486。在PSM之前,多因素分析显示,风险与OS(HR=2.577,95%CI=1.614~4.114,P<0.001)和PFS(HR=2.679,95%CI=1.744~4.114,P<0.001)显著相关。PSM调整后,风险仍然是OS(HR=2.829,95%CI=1.601-5.001,P<0.001)和PFS(HR=2.877,95%CI=1.735-4.770,P<0.001)的独立因素.有了NRI,通过整合风险的改良NRI增加了AUC和临床净获益,降低了Brier积分.
    结论:风险是一种易于获得且廉价的指标,可用作预后指标,并可提高ENKTCL患者的NRI预测能力。
    BACKGROUND: At present, peripheral blood markers are easily accessible information and clinically valuable prognostic indicators in extranodal nasal-type natural killer/T-cell lymphoma (ENKTCL). Nevertheless, the role of its comprehensive score in ENKTCL remains to be determined.
    OBJECTIVE: Therefore, this study aimed to investigate the prognostic effect of the peripheral inflammation score on ENKTCL.
    METHODS: The retrospective study included 183 patients with ENKTCL. Univariate Cox regression analyses and least absolute shrinkage and selection operator (LASSO) Cox regression were used to construct the inflammation-related prognostic index named Risk. Univariate and multivariate Cox regression analyses and regression adjustment with propensity score matching (PSM) were used to evaluate the prognostic ability of risk. The performance of the modified nomogram-revised risk index (NRI) by integrating risk was evaluated with the area under the time-dependent receiver operating characteristic (ROC) curve (AUC), decision curve analysis (DCA), and integrated Brier score (IBS).
    RESULTS: The risk cut-off value, constructed by the lymphocyte count, platelet count, albumin level, LMR, and PNI, was -1.3486. Before PSM, multivariate analysis showed that risk was significantly associated with OS (HR = 2.577, 95% CI = 1.614-4.114, P< 0.001) and PFS (HR = 2.679, 95% CI = 1.744-4.114, P< 0.001). After PSM adjustment, risk was still an independent factor for OS (HR = 2.829, 95% CI = 1.601-5.001, P< 0.001) and PFS (HR = 2.877, 95% CI = 1.735-4.770, P< 0.001). With the NRI, the modified NRI by integrating risk increased the AUC and clinical net benefit and decreased the IBS.
    CONCLUSIONS: Risk is an easily accessible and inexpensive indicator that may be used as a prognostic marker and could improve NRI predictive power in patients with ENKTCL.
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  • 文章类型: Journal Article
    背景:结外自然杀伤/T细胞淋巴瘤,小肠的鼻型(ENKL),是一种预后极差的疾病。我们描述了一种新颖的病例的治疗方法,因为它证明了长期生存。
    方法:一名68岁的男子因患有压痛和肌肉防御的严重脐痛而入院。腹部计算机断层扫描扫描显示小肠上有厚壁肿块和腹内自由空气。他被怀疑患有小肠肿瘤穿孔,并接受了紧急手术。手术显示肿瘤溃疡穿孔,根据术后病理结果诊断为ENKL。患者术后病程顺利。他接受了血液学家的辅助化疗,包括六个疗程的地塞米松,依托泊苷,异环磷酰胺,和卡铂。患者表现出长期生存,在撰写本文时处于缓解状态,手术后4年5个月.
    结论:我们报告了一例罕见的小肠穿孔ENKL长期存活的病例,通过手术和地塞米松辅助化疗,依托泊苷,异环磷酰胺,和卡铂。如果遇到罕见的ENKL术后病理发现,必须咨询血液学家以确定最合适的化学疗法,例如DeVIC。为了阐明这种疾病的病理生理学并延长患病患者的生存期,长期生存病例的积累和相关特征的检查是必要的。
    BACKGROUND: Extranodal natural killer/T-cell lymphoma, nasal type (ENKL) of the small intestine, is a disease with extremely poor prognosis. We describe treatment in a case which is novel in that it demonstrated long-term survival.
    METHODS: A 68-year-old man was admitted to the emergency department of our hospital with the complaint of severe umbilical pain with tenderness and muscular defense. An abdominal computed tomography scan revealed a thick-wall mass on the small intestine and intra-abdominal free air. He was suspected of perforation of a small intestinal tumor and underwent emergency surgery. The surgery revealed a perforated tumor ulcer, and ENKL was diagnosed from the postoperative pathological findings. The patient\'s postoperative course was uneventful. He was further treated with adjuvant chemotherapy by hematologist comprising six courses of dexamethasone, etoposide, ifosfamide, and carboplatin. The patient demonstrated long-term survival and was in remission at the time of writing, four years and five months after surgery.
    CONCLUSIONS: We report a rare case of long-term survival of perforated ENKL of the small intestine achieved by surgery and adjuvant chemotherapy with dexamethasone, etoposide, ifosfamide, and carboplatin. It is essential to consult with a hematologist to determine the most appropriate chemotherapy such as DeVIC if one encounters rare postoperative pathological findings of ENKL. To elucidate the pathophysiology of this disease and to prolong survival of affected patients, accumulation of cases of long-term survival and examination of associated characteristics is necessary.
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  • 文章类型: Case Reports
    复发性多软骨炎(RP)是一种罕见的自身免疫性疾病,在整个身体中发生复发性和进行性软骨炎。我们报告了一例56岁的女性受试者,表现为间歇性发烧和咳嗽,通过支气管镜检查和FDG正电子发射断层扫描/计算机断层扫描(PET/CT)发现她的喉和气管中明显的管腔狭窄和强烈的18F-脱氧葡萄糖(FDG)摄取。耳廓软骨活检显示软骨炎。起初她被诊断为RP,并接受糖皮质激素和甲氨蝶呤治疗,导致完全的反应。18个月后发烧和咳嗽复发,再次进行FDGPET/CT,并针对新发现的鼻咽病变,活检证明是结外自然杀伤(NK)/T细胞淋巴瘤,鼻型。
    Relapsing polychondritis (RP) is a rare autoimmune disease in which recurrent and progressive chondritis occurs throughout the body. We report a case of a 56-year-old female subject presented as intermittent fever and cough, who was found obvious luminal stenosis and intense 18F-fluorodeoxyglucose (FDG) uptake in her larynx and trachea via bronchoscopy and FDG positron emission tomography/computed tomography (PET/CT). The auricular cartilage biopsy demonstrated chondritis. At first she was diagnosed as RP and treated by glucocorticoid and methotrexate, leading to completely response. Fever and cough recurred after 18 months, and FDG PET/CT were performed again and targeted a newfound nasopharyngeal lesion, where the biopsy proved to be an extranodal natural killer (NK)/T-cell lymphoma, nasal type.
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  • 文章类型: Case Reports
    抗SARS-CoV-2疫苗是针对由严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)引起的2019年冠状病毒病(COVID-19)大流行而开发的。尽管BNT162b2mRNA疫苗是有效的,已经报道了不良反应。这里,我们报道一例结外NK/T细胞淋巴瘤,鼻型(ENKL),BNT162b2mRNA疫苗接种后的左臂。一名73岁的男性左臂有肿块,这是他3个月前接受BNT162b2mRNA疫苗的地方。他接受了局部皮质类固醇和清创术治疗,但肿瘤进展了.此外,发烧,盗汗,观察到一般疲劳。实验室检查结果包括血小板减少症,乳酸脱氢酶升高,和可溶性白细胞介素-2受体水平。皮肤活检导致ENKL的诊断。患者接受了50%剂量的SMILE治疗和放疗,导致肿瘤消退。似乎潜伏的爱泼斯坦-巴尔病毒(EBV)感染的NK/T细胞被疫苗接种重新激活,并有助于ENKL的发作。这是ENKL在BNT162b2mRNA接种后的首次报道。本案突出了恶性淋巴瘤发展的可能风险,包括注射部位的ENKL,BNT162b2COVID-19疫苗接种后。
    Anti-SARS-CoV-2 vaccines were developed in response to the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the BNT162b2 mRNA vaccine is effective, adverse effects have been reported. Here, we report a case of extranodal NK/T-cell lymphoma, nasal type (ENKL), of the left arm following BNT162b2 mRNA vaccination. A 73-year-old male presented with a lump in the left arm, which was the site where he received the BNT162b2 mRNA vaccine 3 months prior. He was treated with topical corticosteroids and debridement, but the tumor progressed. Additionally, fever, night sweats, and general fatigue were observed. Laboratory findings included thrombocytopenia, elevated lactate dehydrogenase, and soluble interleukin-2 receptor levels. Skin biopsy led to a diagnosis of ENKL. The patient was treated with a 50% dose of SMILE therapy and radiotherapy, resulting in regression of the tumor. It seems that latent Epstein-Barr virus (EBV)-infected NK/T cells were reactivated by vaccination and contributed to the onset of ENKL. This is the first report of ENKL after BNT162b2 mRNA vaccination. The present case highlights the possible risk of development of malignant lymphoma, including ENKL at the injection site, after BNT162b2 COVID-19 vaccination.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    未经授权:为了评估I/II期结外NK/T细胞淋巴瘤患者的治疗结果,鼻型(ENKTCL-NT)和低剂量放疗(RT)实现完全反应的可行性(CR,定义为在含有l-天冬酰胺酶的化疗(l-ASP)后,在正电子发射断层扫描[PET]上没有残留的高代谢摄取或在计算机断层扫描[CT]上没有残留的病变)。
    UNASSIGNED:在1992年至2018年之间,76例早期ENKTCL-NT患者在诱导化疗后获得CR或部分缓解(PR),接受了辅助RT。RT剂量(使用2Gy分数的生物等效剂量[EQD2])和局部无复发生存率(LRFS),局部无复发生存率(LRRFS),无远处转移生存期(DMFS),无进展生存期(PFS),并确定癌症特异性生存率(CSS)。
    未经评估:中位随访时间为5.1年(范围,0.5-20.8)。中位RT剂量为45Gy(范围,20-54).5年LRFS,LRRFS,DMFS,PFS,CSS率为82.7%,78.2%,81.1%,68.7%,和84.4%,分别。诱导化疗后的CR与每个终点更好的生存结果显著相关。在l-ASP后显示CR的患者中,l-ASP或EQD2<40Gy的施用不影响生存结果。不良事件(AE)≥2级显著降低,EQD2<40Gy,与EQD2≥40Gy相比。
    未经批准:化疗后获得CR是早期ENKTCL-NT生存结局的最具预测因素。在l-ASP后减少CR患者的RT剂量似乎可以最大程度地减少AE的发生,而不会影响LRR的风险;然而,需要更长时间的随访和谨慎的申请。
    UNASSIGNED: To assess treatment outcomes in patients with stage I/II extranodal NK-/T-cell lymphoma, nasal type (ENKTCL-NT) and the feasibility of low-dose radiotherapy (RT) for achieving complete response (CR, defined as showing no residual hypermetabolic uptake on positron emission tomography [PET] or no residual lesions on computed tomography [CT]) after l-asparaginase-containing chemotherapy (l-ASP).
    UNASSIGNED: Between 1992 and 2018, 76 patients with early-stage ENKTCL-NT who achieved CR or partial response (PR) after induction chemotherapy received adjuvant RT. RT doses (using biologically equivalent doses in 2 Gy fractions [EQD2]) and rates of local recurrence-free survival (LRFS), locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and cancer-specific survival (CSS) were determined.
    UNASSIGNED: Median follow-up was 5.1 years (range, 0.5-20.8). The median RT dose was 45 Gy (range, 20-54). The 5-year LRFS, LRRFS, DMFS, PFS, and CSS rates were 82.7 %, 78.2 %, 81.1 %, 68.7 %, and 84.4 %, respectively. CR after induction chemotherapy was notably linked to better survival outcomes across each endpoint. Survival outcomes were not affected either by the administration of l-ASP or EQD2 < 40 Gy in patients displaying CR after l-ASP. Adverse events (AEs) ≥ Grade 2 were significantly reduced with EQD2 < 40 Gy, compared with EQD2 ≥ 40 Gy.
    UNASSIGNED: Achieving CR after chemotherapy was the most predictive factor of survival outcomes in early-stage ENKTCL-NT. Decreasing RT doses in patients with CR after l-ASP appeared to minimize the occurrence of AE without compromising LRR risk; however, longer follow-ups and cautious application are warranted.
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  • 文章类型: Journal Article
    结外自然杀伤(NK)/T细胞淋巴瘤(ENKL)的鼻型是非霍奇金淋巴瘤的侵袭性形式。虽然ENKL最常见于鼻子中线,脸和Waldeyer的戒指,它也可以发生在皮肤上,胃肠道,软组织和身体的其他部位。严重的ENKL病例伴有吞噬作用,临床表现如高烧,肝脾肿大,血细胞计数下降。不同位置的ENKL表现出相似的组织学特征和免疫表型,例如对T细胞标志物CD2和CD56,细胞毒性分子的强亲和力,以及原位杂交后EBER的强阳性。虽然惰性ENKL极为罕见,我们在此提出一个病例研究的原发性NK/T细胞淋巴瘤在椎管内,最初表现为弥漫性生长的小细胞,以及11年后的生存和复发细节,伴有CD30阳性大细胞转化。治疗后患者病情好转,目前身体健康。
    The nasal type of extranodal natural killer (NK)/T-cell lymphoma (ENKL) is an aggressive form of non-Hodgkin\'s lymphoma. Although ENKL is most commonly seen in the midline of the nose, face and Waldeyer\'s ring, it can also occur in the skin, gastrointestinal tract, soft tissues and other parts of the body. Severe ENKL cases are accompanied by hemophagocytosis, with clinical manifestations such as high fever, hepatosplenomegaly, and decreased blood cell count. ENKL at different locations exhibits similar histological features and immunophenotypes, such as a strong affinity for T cell markers CD2 and CD56, cytotoxic molecules, as well as a strong positive for EBER after in situ hybridization. Although indolent ENKL is extremely rare, we hereby present a case study of primary NK/T cell lymphoma in the spinal canal with the initial manifestation of a diffuse growth of small cells, and the survival and recurrence details after 11 years, accompanied by CD30-positive large cell transformation. The patient\'s condition after treatment has improved and is currently in good health.
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  • 文章类型: Case Reports
    背景:急性胰腺炎的主要病因包括胆源性和酒精,尽管各种其他原因包括药物(即,L-天冬酰胺酶)或恶性肿瘤。由于病因的准确识别对于确定治疗计划至关重要,应尽早进行病因评估。
    方法:一名57岁的韩国男子入院接受化疗。患者因宗教原因不饮酒。入院前26天,在超声检查中观察到4cm大小的睾丸肿块,他接受了右放射状睾丸切除术。结外自然杀伤/T细胞淋巴瘤,鼻型,被诊断出来了.确认没有其他异常发现后,化疗(使用地塞米松方案,甲氨蝶呤,异环磷酰胺,L-天冬酰胺酶,和依托泊苷)开始。在化疗的第8天,开始使用L-天冬酰胺酶,2天后他抱怨突然发作的上腹痛。诊断为急性胰腺炎,为了确定急性胰腺炎是否由于L-天冬酰胺酶或结外自然杀伤/T细胞淋巴瘤的胰腺受累而发生,超声内镜引导下进行细针活检,观察弥漫性浸润的肿瘤细胞。因此,由于结外自然杀伤/T细胞淋巴瘤的胰腺受累,他最终被诊断为急性胰腺炎,鼻型。
    结论:结外自然杀伤/T细胞淋巴瘤胰腺受累引起的急性胰腺炎,鼻型,是一种非常罕见的疾病,但可以在化疗期间发生。为了确定急性胰腺炎的病因,超声内镜引导下细针活检可以考虑。
    BACKGROUND: The main etiology of acute pancreatitis includes biliary origin and alcohol, although various other causes include drugs (i.e., L-asparaginase) or malignant tumors. Since accurate identification of etiologies is crucial for determining therapeutic planning, the assessment of cause should be performed as early as possible.
    METHODS: A 57-year-old Korean man was admitted for chemotherapy. The patient did not drink alcohol for religious reason. 26 days prior to admission, a 4 cm-sized testicular mass was observed in ultrasound and he received right radial orchiectomy. Extranodal natural killer/T-cell lymphoma, nasal type, was diagnosed. After confirming no additional abnormal findings, chemotherapy (using the regimens Dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide) was begun. On Day 8 of chemotherapy, L-asparaginase was started and he complained of sudden onset epigastric pain after 2 days. Acute pancreatitis was diagnosed and, in order to determine if the acute pancreatitis occurred due to L-asparaginase or pancreas involvement of extranodal natural killer/T-cell lymphoma, endoscopic ultrasonography guided fine needle biopsy was performed and observed diffusely infiltrated tumor cells. Therefore, he was given a final diagnosis of acute pancreatitis due to pancreas involvement of extranodal natural killer/T-cell lymphoma, nasal type.
    CONCLUSIONS: Acute pancreatitis caused by pancreas involvement of extranodal natural killer/T-cell lymphoma, nasal type, is a very rare disease but can occur during chemotherapy. To identify the cause of acute pancreatitis, endoscopic ultrasonography guided fine needle biopsy can be considered.
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