IJD
Indian Journal of Dermatology
  Publication of IADVL, WB
  Official organ of AADV
Indexed with Science Citation Index (E) , Web of Science and PubMed
 
Users online: 713  
Home About  Editorial Board  Current Issue Archives Online Early Coming Soon Guidelines Subscriptions  e-Alerts    Login  
    Small font sizeDefault font sizeIncrease font size Print this page Email this page


 
DRUG REVIEW
Year : 2006  |  Volume : 51  |  Issue : 4  |  Page : 292-293
Progressive destructive lesion of the midface with multiple cutaneous deposits


1 Department of Dermatology, RG Kar Medical College, Kolkata, India
2 Department of Plastic Surgery, RG Kar Medical College, Kolkata, India
3 Department of Otorhinolaryngology, Medical College Calcutta, Kolkata, India

Correspondence Address:
Nilay Kanti Das
Devitala Road, Majerpara, Ishapore, North 24 Paraganas - 743144
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.30300

Rights and Permissions



How to cite this article:
Das NK, Saha VP, Ghosh B, Saha S, Datta PK. Progressive destructive lesion of the midface with multiple cutaneous deposits. Indian J Dermatol 2006;51:292-3

How to cite this URL:
Das NK, Saha VP, Ghosh B, Saha S, Datta PK. Progressive destructive lesion of the midface with multiple cutaneous deposits. Indian J Dermatol [serial online] 2006 [cited 2020 Nov 29];51:292-3. Available from: https://www.e-ijd.org/text.asp?2006/51/4/292/30300


A 54-year-old male was admitted with the history of left-sided recurrent unilateral epistaxis and nasal obstruction for 3 months due to a rapidly increasing swelling over left nostril and cheek adjacent to the nasolabial furrow. The swelling was associated with mild pain, which progressed to intense pain during the later period. On examination an ulcerated mass with areas of necrosis was noted in left nasal cavity causing destruction of the nasal cartilaginous framework and gingivo-labial sulcus [Figure - 1]. Following admission he developed multiple subcutaneous swellings with overlying ulceration on the forearm, elbow and leg [Figure - 2]. A clinically enlarged liver was found though there was no evidence of lymphadenopathy or splenomegaly or sternal tenderness.

CT scan revealed deficient anterior cartilaginous part of nasal septum and left nasal ala with no mass in maxillary antrum, nasal cavity or turbinates [Figure - 3]. CBC showed pancytopenia and both c-ANCA and ELISA for HIV was negative. Serum lactate dehydrogenase was found to be 850 U/mL and USG of upper abdomen showed multiple SOL in both lobes of liver. Deeper biopsies from ulcer margin revealed polymorphous infiltrate with atypical lymphoid cells showing angiocentric distribution and scattered areas of necrosis with no evidence of vasculitis neither any tendency of granuloma formation [Figure - 4]a. Immunostaining showed CD3- and CD56+ phenotype [Figure - 4]b.


   Questions Top


  1. What is the diagnosis?
  2. What are the clinical differential diagnoses?
  3. What are the factors playing a role in its etio-pathogenesis?
  4. What are the immunological markers available for the diagnosis of the condition?



   Answers Top




Click here to view answer. View Answer


 
   References Top

1.Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J, et al . World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: Report of the clinical advisory committee meeting. J Clin Oncol 1999;17:3835-49.  Back to cited text no. 1      
2.Chim CS, Ma ES, Loong F, Kwong YL. Diagnostic cues for natural killer cell lymphoma: Primary nodal presentation and the role of in situ hybridisation for Epstein-Barr virus encoded early small RNA in detecting occult bone marrow involvement. J Clin Pathol 2005;58:443-5.  Back to cited text no. 2      
3.Nigidie A, Schneider J. Nasal NK/T-cell lymphoma causing diagnostic difficulties. Ethiop Med J 2005;43:197-201.  Back to cited text no. 3      
4.LeBoit PE, McCalmont TH. Cutaneous lymphomas and leukemias. In : Lever's histopathology of the skin. Elder D, Elenitus R, Jaworsky C, Johnson B Jr, editors. 8th ed. Linppincott Williams and Wilkins: Philadelphia; 1997. p. 805-46.  Back to cited text no. 4      
5.Jaffe ES, Chan JK, Su IJ, Frizzera G, Mori S, Feller AC, et al . Report of the workshop on nasal and related extranodal angiocentric T/natural killer cell lymphoma. Definitions, differential diagnosis and epidemiology. Am J Surg Pathol 1996;20:103-11.  Back to cited text no. 5      
6.Ooi GC, Chim CS, Liang R, Tsang KW, Kwong YL. Nasal T-cell/natural killer cell lymphoma: CT and MR imaging features of a new clinicopathologic entity. AJR Am J Roentgenol 2000;174:1141-5.  Back to cited text no. 6      
7.Mendenhall WM, Olivier KR, Lynch JW Jr, Mendenhall NP. Lethal midline granuloma-nasal natural killer/T-cell lymphoma. Am J Clin Oncol 2006;29:202-6.   Back to cited text no. 7      
8.Tamai Y, Imataki O, Abe Y, Hagiwara S, Ito I, Asakura H, et al . Case series of localized nasal NK/T-cell lymphoma treated with preceding intensified local radiation therapy before systemic chemotherapy. Gan To Kagaku Ryoho 2006;33:687-90.  Back to cited text no. 8      
9.Skitarelic N, Dominis M, Matulic Z, Dujella J, Dzelalija B. Lethal midline granuloma. Lijec Vjesn 2004;126:129-32.   Back to cited text no. 9      
10.Rodrigo JP, Suarez C, Rinaldo A, Devaney KO, Carbone A, Barnes L, et al . Idiopathic midline destructive disease: Fact or fiction. Oral Oncol 2005;41:340-8.  Back to cited text no. 10      
11.Borges A, Fink J, Villablanca P, Eversole R, Lufkin R. Midline destructive lesions of the sinonasal tract: Simplified terminology based on histopathologic criteria. AJNR Am J Neuroradiol 2000;21:331-6.  Back to cited text no. 11      
12.Peh SC, Quen QW. Nasal and nasal-type natural killer (NK)/T-cell lymphoma: Immunophenotype and Epstein-Barr virus (EBV) association. Med J Malaysia 2003;58:196-204.  Back to cited text no. 12      
13.Takahara M, Kishibe K, Bandoh N, Nonaka S, Harabuchi Y. P53, N- and K-Ras and beta-catenin gene mutations and prognostic factors in nasal NK/T-cell lymphoma from Hokkaido, Japan. Hum Pathol 2004;35:86-95.  Back to cited text no. 13      
14.Takakuwa T, Dong Z, Nakatsuka S, Kojya S, Harabuchi Y, Yang WI, et al . Frequent mutations of Fas gene in nasal NK/T cell lymphoma. Oncogene 2002;21:4702-5.  Back to cited text no. 14      
15.Jaffe ES, Chan JK, Su IJ, Frizzera G, Mori S, Feller AC, et al . Report of the workshop on nasal and related extranodal angiocentric T/natural killer cell lymphoma. Definitions, differential diagnosis and epidemiology. Am J Surg Pathol 1996;20:103-11.  Back to cited text no. 15      
16.Nagata H, Konno A, Kimura N, Zhang Y, Kimura M, Demachi A, et al . Characterization of novel natural killer (NK)-cell and gammadelta T-cell lines established from primary lesions of nasal T/NK-cell lymphomas associated with the Epstein-Barr virus. Blood 2001;97:708-13.  Back to cited text no. 16      
17.Wong KF, Chan JK, Cheung MM, So JC. Bone marrow involvement by nasal NK cell lymphoma at diagnosis is uncommon. Am J Clin Pathol 2001;115:266-70.  Back to cited text no. 17      


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]



 

Top
Print this article  Email this article
 
  Search
 
   Next article
   Previous article 
   Table of Contents
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (650 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


    Questions
    Answers
    References
    Article Figures

 Article Access Statistics
    Viewed4185    
    Printed90    
    Emailed1    
    PDF Downloaded136    
    Comments [Add]    

Recommend this journal