Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Case report

Extranodal natural killer/T-cell lymphoma in Malawi: a report of three cases

Authors: Tamiwe Tomoka, Eric Powers, Toon van der Gronde, Amy Amuquandoh, Bal Mukunda Dhungel, Coxcilly Kampani, Steve Kamiza, Nathan D. Montgomery, Yuri Fedoriw, Satish Gopal

Published in: BMC Cancer | Issue 1/2017

Login to get access

Abstract

Background

Extranodal NK/T-cell lymphoma (ENKTCL) reports from sub-Saharan Africa (SSA) are remarkably rare, despite early childhood acquisition and high prevalence of the causative infectious agent, Epstein-Barr virus (EBV), and frequent occurrence of other lymphoproliferative disorders causally associated with EBV.

Case presentations

At a national teaching hospital in Malawi, three patients of African descent were seen with ENKTCL between 2013 and 2014. Patients were aged between 29 and 60 years, two with craniofacial involvement and one with a primary abdominal tumor, and all were HIV-negative. All had systemic B symptoms, and two severely impaired performance status. On histologic review, morphology and immunophenotyping demonstrated classical ENKTCL features in all cases, including diffuse proliferations of intermediate-to-large atypical lymphocytes with high mitotic activity and extensive background necrosis, positivity for CD3 and CD56, and negativity for CD20. By in situ hybridization, all three tumors were positive for EBV-encoded RNA (EBER). Baseline plasma EBV DNA was also markedly elevated for all three patients. Due to radiotherapy and chemotherapy limitations, patients were treated with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) with rapid disease progression. All three patients died from progressive lymphoma within 3 months of initial diagnosis.

Conclusions

Our experience with these three patients in Malawi can highlight that ENKTCL does indeed occur in SSA, increase familiarity with ENKTCL among clinicians and pathologists throughout the region, and emphasize the need for better diagnosis and treatment for this neglected population.
Literature
1.
Gopal S, Krysiak R, Liomba NG, et al. Early experience after developing a pathology Laboratory in Malawi, with emphasis on cancer diagnoses. PLoS One. 2013;8(8):e70361.CrossRefPubMedPubMedCentral
2.
Jaffe ES, Harris NL, Stein H, et al. Introduction and overview of the classification of the lymphoid neoplasms. In: Swerdlow SH, Campo E, Harris NL, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC; 2008. p. 157–66.
3.
Chan JKC, Quintanilla-Martinez L, Ferry JA, et al. Extranodal NK/T lymphoma nasal type. In: Swerdlow SH, Campo E, Harris NL, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC; 2008. p. 285–8.
4.
Huang WT, Huang CC, Weng SW, Eng HL. Expression of the multidrug resistance protein MRP and the lung-resistance protein LRP in nasal NK/T cell lymphoma: further exploring the role of P53 and WT1 gene. Pathology. 2009;41(2):127–32.CrossRefPubMed
5.
Au WY, Ma SY, Chim CS, et al. Clinicopathologic features and treatment outcome of mature T-cell and natural killer-cell lymphomas diagnosed according to the World Health Organization classification scheme: a single center experience of 10 years. Ann Oncol. 2005;16(2):206–14.CrossRefPubMed
6.
Laurini JA, Perry AM, Boilesen E, et al. Classification of non-Hodgkin lymphoma in central and South America: a review of 1028 cases. Blood. 2012;120(24):4795–801.CrossRefPubMed
7.
Peh SC. Host ethnicity influences non-Hodgkin’s lymphoma subtype frequency and Epstein-Barr virus association rate: the experience of a multi-ethnic patient population in Malaysia. Histopathology. 2001;38(5):458–65.CrossRefPubMed
8.
Adams SV, Newcomb PA, Shustov AR. Racial patterns of peripheral T-cell lymphoma incidence and survival in the United States. J Clin Oncol. 2016;34(9):963–71.CrossRefPubMedPubMedCentral
9.
Trimeche M, et al. Prevalence of Epstein-Barr virus in non-Hodgkin’s lymphomas in central region of Tunisia. Ann Pathol. 2005;25(2):95–102.CrossRefPubMed
10.
Kouassi YM, Vroh BT, Amelin IH, et al. A case of nasal NK/T cell lymphoma in Africa. Rev Laryngol Otol Rhinol (Bord). 2011;132(4–5):255–7.
11.
Tiholoe MM, Kotu M, Khammisa RA, et al. Extranodal natural killer/T-cell lymphoma, nasal type: ‘midline lethal granuloma’. a case report. Head Face Med. 2013;9:4.CrossRef
12.
Sabageh D, Solaja TO, Olasode BJ. Malignant tumors of the upper aerodigestive tract as seen in a Nigerian tertiary health institution. Niger J Clin Pract. 2015;18(2):231–5.CrossRefPubMed
13.
Onakoya PA, Adeyi OA, Nwaorgu OG, et al. Primary extranodal non-Hodgkin’s lymphoma of the upper aerodigestive tract--a descriptive analysis of the pattern seen in the University College Hospital, Ibadan. Afr J Med Med Sci. 2003;32(1):59–63.PubMed
14.
Hirakawa S, Kuyama M, Takahashi S, et al. Nasal and nasal-type natural killer/T-cell lymphoma. J Am Acad Dermatol. 1999;40(2):268–72.CrossRefPubMed
15.
Luzi P, et al. Epstein-Barr virus infection in sinonasal non-Hodgkin’s lymphomas. Virchows Arch. 1994;25(2):121–5.
16.
Au W, Pang A, Choy C, Chim C, Kwong Y, Dc W. Quantification of circulating Epstein-Barr virus ( EBV ) DNA in the diagnosis and monitoring of natural killer cell and EBV-positive lymphomas in immunocompetent patients. Blood. 2011;104(1):243–9.CrossRef
Metadata
Title
Extranodal natural killer/T-cell lymphoma in Malawi: a report of three cases
Authors
Tamiwe Tomoka
Eric Powers
Toon van der Gronde
Amy Amuquandoh
Bal Mukunda Dhungel
Coxcilly Kampani
Steve Kamiza
Nathan D. Montgomery
Yuri Fedoriw
Satish Gopal
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3612-y

Other articles of this Issue 1/2017

BMC Cancer 1/2017 Go to the issue

Research article

The XRCC 1 DNA repair gene modifies the environmental risk of stomach cancer: a hospital-based matched case-control study

Research article

Sertad1 antagonizes iASPP function by hindering its entrance into nuclei to interact with P53 in leukemic cells

Study protocol

A protocol for a cluster-randomized controlled trial of a self-help psycho-education programme to reduce diagnosis delay in women with breast cancer symptoms in Indonesia

Study protocol

The effect of geriatric intervention in frail elderly patients receiving chemotherapy for colorectal cancer: a randomized trial (GERICO)

Research article

A novel chemotherapeutic sensitivity-testing system based on collagen gel droplet embedded 3D–culture methods for hepatocellular carcinoma

Research article

Clusterin modulates transdifferentiation of non-small-cell lung cancer
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits