Uveitis and Myositis as Immune Complications in Chemorefractory NK/T-Cell Nasal-Type Lymphoma Successfully Treated with Allogeneic Stem-Cell Transplant

NK/T-cell lymphomas are a group of clonal proliferations of NK- or, rarely, T-cell types and have peculiar clinicopathologic features. Most common site of involvement is the upper aerodigestive tract (nasal cavity, nasopharynx, paranasal sinuses, and palate). Association of autoimmune paraneoplastic...

Full description

Saved in:
Bibliographic Details
Main Authors: Maria José Gómez-Crespo, Aránzazu García-Raso, Jose Luis López-Lorenzo, Teresa Villaescusa, María Rodríguez-Pinilla, José Fortes, Cristina Serrano, Salma Machan, Pilar Llamas, Raúl Córdoba
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2016/7297920
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850162168056512512
author Maria José Gómez-Crespo
Aránzazu García-Raso
Jose Luis López-Lorenzo
Teresa Villaescusa
María Rodríguez-Pinilla
José Fortes
Cristina Serrano
Salma Machan
Pilar Llamas
Raúl Córdoba
author_facet Maria José Gómez-Crespo
Aránzazu García-Raso
Jose Luis López-Lorenzo
Teresa Villaescusa
María Rodríguez-Pinilla
José Fortes
Cristina Serrano
Salma Machan
Pilar Llamas
Raúl Córdoba
author_sort Maria José Gómez-Crespo
collection DOAJ
description NK/T-cell lymphomas are a group of clonal proliferations of NK- or, rarely, T-cell types and have peculiar clinicopathologic features. Most common site of involvement is the upper aerodigestive tract (nasal cavity, nasopharynx, paranasal sinuses, and palate). Association of autoimmune paraneoplastic disorders with NK/T-cell lymphomas is not well studied. Our patient was diagnosed with NK/T-cell lymphoma stage IV with skin involvement and treated frontline with CHOEP regimen. While he was under treatment, two immune complications presented: anterior uveitis of autoimmune origin refractory to steroids and myositis in lower limbs muscles. Autologous transplantation was rejected due to confirmed early relapse after first-line treatment, and the patient received second-line treatment according to the SMILE scheme, reaching complete response after four cycles. The patient underwent allogeneic transplantation and at the time of manuscript preparation is alive despite multiple complications. The disease should be suspected in patients with rhinitis or recurrent sinusitis, and early biopsy is recommended for all patients to avoid a delay in diagnosis. Our patient also presented symptoms of disease progression after first-line treatment, representing a paraneoplastic process, a very rare phenomenon in T-type lymphomas. This case is novel for the appearance of an inflammatory myositis, a histologically verified paraneoplastic phenomenon that responded to treatment for lymphoma.
format Article
id doaj-art-fd93c7e794814a36b2016434375b79ce
institution OA Journals
issn 2090-6560
2090-6579
language English
publishDate 2016-01-01
publisher Wiley
record_format Article
series Case Reports in Hematology
spelling doaj-art-fd93c7e794814a36b2016434375b79ce2025-08-20T02:22:38ZengWileyCase Reports in Hematology2090-65602090-65792016-01-01201610.1155/2016/72979207297920Uveitis and Myositis as Immune Complications in Chemorefractory NK/T-Cell Nasal-Type Lymphoma Successfully Treated with Allogeneic Stem-Cell TransplantMaria José Gómez-Crespo0Aránzazu García-Raso1Jose Luis López-Lorenzo2Teresa Villaescusa3María Rodríguez-Pinilla4José Fortes5Cristina Serrano6Salma Machan7Pilar Llamas8Raúl Córdoba9Lymphoma Unit, Department of Hematology, Fundación Jiménez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, SpainLymphoma Unit, Department of Hematology, Fundación Jiménez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, SpainLymphoma Unit, Department of Hematology, Fundación Jiménez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, SpainLymphoma Unit, Department of Hematology, Fundación Jiménez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, SpainDepartment of Pathology, Fundación Jiménez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, SpainDepartment of Pathology, Fundación Jiménez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, SpainLymphoma Unit, Department of Hematology, Fundación Jiménez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, SpainDepartment of Dermatology, Fundación Jiménez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, SpainLymphoma Unit, Department of Hematology, Fundación Jiménez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, SpainLymphoma Unit, Department of Hematology, Fundación Jiménez Díaz University Hospital, Health Research Institute IIS-FJD, Madrid, SpainNK/T-cell lymphomas are a group of clonal proliferations of NK- or, rarely, T-cell types and have peculiar clinicopathologic features. Most common site of involvement is the upper aerodigestive tract (nasal cavity, nasopharynx, paranasal sinuses, and palate). Association of autoimmune paraneoplastic disorders with NK/T-cell lymphomas is not well studied. Our patient was diagnosed with NK/T-cell lymphoma stage IV with skin involvement and treated frontline with CHOEP regimen. While he was under treatment, two immune complications presented: anterior uveitis of autoimmune origin refractory to steroids and myositis in lower limbs muscles. Autologous transplantation was rejected due to confirmed early relapse after first-line treatment, and the patient received second-line treatment according to the SMILE scheme, reaching complete response after four cycles. The patient underwent allogeneic transplantation and at the time of manuscript preparation is alive despite multiple complications. The disease should be suspected in patients with rhinitis or recurrent sinusitis, and early biopsy is recommended for all patients to avoid a delay in diagnosis. Our patient also presented symptoms of disease progression after first-line treatment, representing a paraneoplastic process, a very rare phenomenon in T-type lymphomas. This case is novel for the appearance of an inflammatory myositis, a histologically verified paraneoplastic phenomenon that responded to treatment for lymphoma.http://dx.doi.org/10.1155/2016/7297920
spellingShingle Maria José Gómez-Crespo
Aránzazu García-Raso
Jose Luis López-Lorenzo
Teresa Villaescusa
María Rodríguez-Pinilla
José Fortes
Cristina Serrano
Salma Machan
Pilar Llamas
Raúl Córdoba
Uveitis and Myositis as Immune Complications in Chemorefractory NK/T-Cell Nasal-Type Lymphoma Successfully Treated with Allogeneic Stem-Cell Transplant
Case Reports in Hematology
title Uveitis and Myositis as Immune Complications in Chemorefractory NK/T-Cell Nasal-Type Lymphoma Successfully Treated with Allogeneic Stem-Cell Transplant
title_full Uveitis and Myositis as Immune Complications in Chemorefractory NK/T-Cell Nasal-Type Lymphoma Successfully Treated with Allogeneic Stem-Cell Transplant
title_fullStr Uveitis and Myositis as Immune Complications in Chemorefractory NK/T-Cell Nasal-Type Lymphoma Successfully Treated with Allogeneic Stem-Cell Transplant
title_full_unstemmed Uveitis and Myositis as Immune Complications in Chemorefractory NK/T-Cell Nasal-Type Lymphoma Successfully Treated with Allogeneic Stem-Cell Transplant
title_short Uveitis and Myositis as Immune Complications in Chemorefractory NK/T-Cell Nasal-Type Lymphoma Successfully Treated with Allogeneic Stem-Cell Transplant
title_sort uveitis and myositis as immune complications in chemorefractory nk t cell nasal type lymphoma successfully treated with allogeneic stem cell transplant
url http://dx.doi.org/10.1155/2016/7297920
work_keys_str_mv AT mariajosegomezcrespo uveitisandmyositisasimmunecomplicationsinchemorefractorynktcellnasaltypelymphomasuccessfullytreatedwithallogeneicstemcelltransplant
AT aranzazugarciaraso uveitisandmyositisasimmunecomplicationsinchemorefractorynktcellnasaltypelymphomasuccessfullytreatedwithallogeneicstemcelltransplant
AT joseluislopezlorenzo uveitisandmyositisasimmunecomplicationsinchemorefractorynktcellnasaltypelymphomasuccessfullytreatedwithallogeneicstemcelltransplant
AT teresavillaescusa uveitisandmyositisasimmunecomplicationsinchemorefractorynktcellnasaltypelymphomasuccessfullytreatedwithallogeneicstemcelltransplant
AT mariarodriguezpinilla uveitisandmyositisasimmunecomplicationsinchemorefractorynktcellnasaltypelymphomasuccessfullytreatedwithallogeneicstemcelltransplant
AT josefortes uveitisandmyositisasimmunecomplicationsinchemorefractorynktcellnasaltypelymphomasuccessfullytreatedwithallogeneicstemcelltransplant
AT cristinaserrano uveitisandmyositisasimmunecomplicationsinchemorefractorynktcellnasaltypelymphomasuccessfullytreatedwithallogeneicstemcelltransplant
AT salmamachan uveitisandmyositisasimmunecomplicationsinchemorefractorynktcellnasaltypelymphomasuccessfullytreatedwithallogeneicstemcelltransplant
AT pilarllamas uveitisandmyositisasimmunecomplicationsinchemorefractorynktcellnasaltypelymphomasuccessfullytreatedwithallogeneicstemcelltransplant
AT raulcordoba uveitisandmyositisasimmunecomplicationsinchemorefractorynktcellnasaltypelymphomasuccessfullytreatedwithallogeneicstemcelltransplant