Primary small intestinal natural killer/T cell lymphoma mimicking tuberculous peritonitis: report of a case and review of the literature.

Extranodal natural killer/T cell lymphoma is very rarely encountered in clinical practice. It has a high mortality rate and very short median survival. Early diagnosis of these rare tumors, especially those originating from the small intestine, is usually difficult because of its nonspecific symptoms. Herein, we describe a case of a primary small intestinal natural killer/T cell lymphoma in a 52-year-old man who presented with abdominal fullness and weight loss. The clinical symptoms, elevation of serum levels of cancer antigen-125, and presence of ascites initially led to the suspicion of tuberculous peritonitis. Abdominal computed tomography scan demonstrated a hypodense tumor in the jejunum. Finally, the tumor was surgically confirmed to be a natural killer/T-cell lymphoma. Although aggressive chemotherapy was prescribed, the patient subsequently died of disease progression. In addition, we also review the English literature on this rare disease.

[1]  T. Sugihara,et al.  CD8+, CD56+ (natural killer‐like) T‐cell lymphoma involving the small intestine with no evidence of enteropathy: Clinicopathology and molecular study of five Japanese patients , 2008, Pathology international.

[2]  K. Higuchi,et al.  Primary CD56+ NK/T-cell lymphoma of the rectum accompanied with refractory ulcerative colitis , 2008, Journal of Gastroenterology.

[3]  K. Ohshima,et al.  Extranodal NK/T‐cell lymphoma: diagnosis and treatment cues , 2008, Hematological oncology.

[4]  V. Valek,et al.  A shift in the diagnostics of the small intestine tumors. , 2007, European journal of radiology.

[5]  M. Czuczman,et al.  The role of surgical intervention in non-Hodgkin's lymphoma of the colon and rectum. , 2007, American journal of surgery.

[6]  M. Arrese,et al.  Value of Adenosine Deaminase (ADA) in Ascitic Fluid for the Diagnosis of Tuberculous Peritonitis: A Meta-analysis , 2006, Journal of clinical gastroenterology.

[7]  O. Bairey,et al.  Serum CA 125 as a Prognostic Factor in Non-Hodgkin's Lymphoma , 2003, Leukemia & lymphoma.

[8]  Dong Ki Lee,et al.  Primary CD56+ T/NK cell lymphoma of the colon , 2002, Journal of Gastroenterology.

[9]  D. Torun,et al.  Abdominopelvic tuberculosis simulating disseminated ovarian carcinoma with elevated CA-125 level: report of two cases , 2002, Abdominal Imaging.

[10]  P. Colombat,et al.  A new serologic index for low-grade non-Hodgkin's lymphoma based on initial CA125 and LDH serum levels. , 2000, Annals of oncology : official journal of the European Society for Medical Oncology.

[11]  B. Comert,et al.  CA-125; a new marker for diagnosis and follow-up of patients with tuberculous peritonitis. , 2000, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[12]  A. Kadayifci,et al.  Elevated serum CA 125 concentration in patients with tuberculous peritonitis: a case-control study. , 1997, The American journal of gastroenterology.

[13]  C. Hsiao,et al.  Angiocentric T-cell lymphoma of the intestine: a distinct etiology of ischemic bowel disease. , 1996, Gastroenterology.

[14]  H. Verbrugh,et al.  CA 125 secretion by peritoneal mesothelial cells. , 1994, Journal of clinical pathology.

[15]  D. Dunn.  Vaccines and antibody immunotherapy in surgical patients. , 1987, American journal of surgery.