Extranodal natural killer T cell lymphoma of the oropharyx: case report

Background T cell lymphoma of the upper aerodigestive tract is a rare entity usually presenting as midfacial ulcerative lesion. It is extremely rare to present as non-healing erosive lesion of the oropharynx. Case presentation A 29-year-old female patient presented with odynophagia and trismus for s...

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Bibliographic Details
Published in:The Egyptian journal of otolaryngology 2021-12, Vol.37 (1), p.83-4, Article 83
Main Authors: Abou-Halawa, Ashraf Saad, Ibrahim, Ibrahim Hassan, Eid, Mahmoud Hassan, Ahmed, Mohamed Rifaat
Format: Article
Language:English
Subjects:
Antibiotics
Biopsy
Cancer
Case Report
Case reports
Chemotherapy
Consent
Diagnosis
Ethics
Hepatitis
Local anesthesia
Lymphatic system
Lymphocytes
Lymphoma
Lymphoma, Extra-nodal, Palate, Ulcer
Medicine
Medicine & Public Health
Mouth
Non-Hodgkin's lymphomas
Nose
Patients
Radiation therapy
Surgery
T cells
Tongue
Tumors
Ulcers
Vincristine
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Summary:Background T cell lymphoma of the upper aerodigestive tract is a rare entity usually presenting as midfacial ulcerative lesion. It is extremely rare to present as non-healing erosive lesion of the oropharynx. Case presentation A 29-year-old female patient presented with odynophagia and trismus for several months. An “inflammatory” oropharyngeal ulcer was diagnosed and she was treated with repeated courses of antibiotics and corticosteroids without response. Recently, she had some blood stained saliva and vomited fresh blood. When seen, she had extensive painful ulcer eroding the right side of the soft palate and right tonsillar area. The ulcer had a whitish floor and ragged border without any tendency to heal. A second biopsy was taken and proved the lesion to be extranodal natural killer T cell lymphoma (ENKTL). The patient was treated with a modified SMILE (steroid, methotrexate, ifosfamide, l -asparaginase, and etoposide) protocol. Conclusions Extranodal natural killer T cell lymphoma can manifest first in the oropharynx. If left untreated it may lead to deep erosive lesion and major oral bleeding. SMILE chemotherapy protocol was used in our patient with good early response.
ISSN:1012-5574
2090-8539
DOI:10.1186/s43163-021-00148-z