皮膚病変を認めたNasal paranasal oropharyngeal lymphomaの2例

概要

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Two cases of malignant lymphoma with skin and naso-pharyngeal involvement were reported.Case 1: A 22-year-old man noticed subcutaneus nodules on the trunk and the upper arm 2 years ago. He began to have sore throat about one year ago. An endoscopic examination revealed white tumors on the middle pharynx. Atypical cells in biopsy specimens of the tumors from the skin were positive for CD45, CD3, CD4 and CD5, and negative for L-26 and CD19. The patient died from loss of blood from his pharyngeal lesion, after two courses of CHOP therapy and one course of MEPP therapy.Case 2: A 44-year-old man had the nasal obstruction for eight months. He noticed numerous erythemas on his back and a mass expanding from his upper palate to his gingiva 2 months before admission. Atypical cells in biopsy specimens were positive for only CD8 and CD56, and negative for CD3, CD4, CD5, CD19 and CD45Ro. We considered that these cells originate from natural killer cell lineage. In addition, these cells were revealed positive for Epstein-Barr early region (EBER) RNA using in situ hybridization. He was treated with three courses of BACOP-BEP therapy, but he died of DIC after 2 months of his admission.In conclusion, our patients tumors were diagnosed as naso-pharyngeal malignant lymphoma associated with skin involvement. The present cases suggest that the management of naso-pharyngeal lymphoma is very difficult.