Literature Review On Cutaneous Extranodal NK/T Cell Lymphoma Nasal Type Cases

Objective: To elucidate the clinical characteristics of cutaneous extranodal NK/T cell lymphoma nasal type(CENKTL)and to enrich the knowledge of diagnosis,treatment and prognosis of CENKTL.Methods: By searching domestic and foreign databases,collect cases of CENKTL with skin manifestations and histopathologically confirmed,and summarized in terms of age,gender,clinical manifestations,laboratory examination,histopathological manifestations,immunohistochemical analysis,imaging examination,follow-up treatment and prognosis.Results:(?)All of the 85 CENKTL patients,17 had been misdiagnosed with other skin diseases.(?)85 CENKTL cases:.1.General condition:Among the 85 cases of CENKTL,there were 37 males(43.5%)and 48 females(56.5%).The average age is 46.32±18.29 years.2.The typical features: Most skin lesions originate in the head,face or limbs,and gradually involve the trunk.Skin lesions are multiple.The manifestations include red or purplish red infiltrating plaques and nodules,which are prone to ulceration,necrosis and scab,and are similar to vasculitis or lipomembranitic lesions.3.When skin lesions were found,75.3% of the patients were successively found to have other lesions,including lymph nodes(28.2%),nasal cavity and or sinus(37.6%),liver and spleen(11.8%),eyes(7.1%),testicles(2.4%),gastrointestinal(2.4%),etc.42.4% of the patients had systemic symptoms of fever,night sweats and weight loss.4.Auxiliary examination:Plasma EBVDNA(EBVDNA)was positive in 91% of patients.Skin histopathological examination of all patients showed dermal and subcutaneous fat lymphocyte infiltration with mitotic images.In 78 immunohistochemical cases,the average positive rates of T,NK and B cell differentiation antigen respectively were 83%,85.5% and 14.8%.The positive rate ofepstein-barr virus in situ hybridization was 89.8%.The imaging examination of the lesion showed that the pet-ct positive rate was 88.9%.5.Treatment :6 patients were treated with radiotherapy alone,32 with chemotherapy alone,20 with combined chemoradiotherapy,and 7 with sequential hematopoietic stem cell transplantation after chemotherapy.6.Prognosis: A total of 58 cases provided prognostic data,of which 24 cases improved after treatment and 34 cases died.The mean total survival was 9.94±16.21 months,and the mean progression-free survival was 9.20±16.41 months.(?)CENKTL misdiagnosed: 17 cases were misdiagnosed as other skin diseases,including cellulitis,dermatominitis,lipomembranitis and becket disease.Conclusion:Multiple,pleomorphic plaques,nodules and chronic ulcerations are the main manifestations in CENKTL.Histopathology and immunohistochemical examination are important bases for determining the diagnosis.Epstein-barr virus examination is positive which has suggestive effect for disease diagnosising.The prognosis was worse than that of the nose.