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Extranodal NK-T-cell lymphoma diagnostic study of choice

Introduction

Overview

Overview

combination of these two findings on immunophenotyping of frozen section specimen cells and RT-PCR are confirmatory for Extranodal NK/T cell lymphoma:Detection of CD56 and EBER1 on tumor cells and EBV DNA (RT-PCR).Pathological examination of frozen section specimen may misled the NK/T cell diagnosis.Circulating cell free EBV DNA levels by RT-PCR is a diagnostic factor for EBV associated malignancies, Like extranodal NK/T cell lymphoma. Measuring both BamHI W DNA and LMP1 DNA is more useful as a prognosis predictor, these DNAs will decrease with treatment and increase with relapse. Recently, determination of negative immune checkpoints are considered as a drug target,in the case of extranodal NK/T cell lymphoma, PD-L1 will be expressed in the tumor, and patients with higher concentration of soluble PD-L1 showed worse prognosis.

Diagnostic Study of Choice

Diagnostic Study of Choice

Study of choice

Investigations:

  • Pathological examination of frozen section specimen may misled the NK/T cell diagnosis.[1]
  • Circulating cell free EBV DNA levels by RT-PCR is a diagnostic factor for EBV associated malignancies, Like extranodal NK-T cell lymphoma.[2][3]
  • Measuring both BamHI W DNA and LMP1 DNA is more useful as a prognosis predictor, these DNAs will decrease with treatment and increase with relapse.[4]
  • Recently, determination of negative immune checkpoints are considered as a drug target,in the case of extranodal NK/T cell lymphoma, PD-L1 will be expressed in the tumor, and patients with higher concentration of soluble PD-L1 showed worse prognosis.[5][6]

Diagnostic results

  • The accompaniment of following findings on performing immunophenotyping on frozen section specimen and RT-PCR are confirmatory for Extranodal NK/T cell lymphoma:
    • Detection of CD56 and EBER1 on tumor cells[7]
    • EBV DNA (RT-PCR)[3]
References

References

  1. ↑ Harabuchi, Yasuaki; Takahara, Miki; Kishibe, Kan; Nagato, Toshihiro; Kumai, Takumi (2019). “Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type: Basic Science and Clinical Progress”. Frontiers in Pediatrics. 7. doi:10.3389/fped.2019.00141. ISSN 2296-2360.
  2. ↑ Lei, Kenny I. K.; Chan, Lisa Y.S.; Chan, Wing Y.; Johnson, Philip J.; Lo, Y. M. Dennis (2000). “Quantitative analysis of circulating cell-free Epstein-Barr virus (EBV) DNA levels in patients with EBV-associated lymphoid malignancies”. British Journal of Haematology. 111 (1): 239–246. doi:10.1046/j.1365-2141.2000.02344.x. ISSN 0007-1048.
  3. ↑ 3.0 3.1 Harabuchi, Yasuaki; Imai, Shosuke; Wakashima, Junichi; Hirao, Motoyasu; Kataura, Akikatsu; Osato, Toyoro; Kon, Shinichiro (1996). “Nasal T-cell lymphoma causally associated with Epstein-Barr virus: Clinicopathologic, phenotypic, and genotypic studies”. Cancer. 77 (10): 2137–2149. doi:10.1002/(SICI)1097-0142(19960515)77:10<2137::AID-CNCR27>3.0.CO;2-V. ISSN 0008-543X.
  4. ↑ Ishii, Hideyuki; Ogino, Takeshi; Berger, Christoph; Köchli-Schmitz, Nicole; Nagato, Toshihiro; Takahara, Miki; Nadal, David; Harabuchi, Yasuaki (2007). “Clinical usefulness of serum EBV DNA levels of BamHI W and LMP1 for Nasal NK/T-cell lymphoma”. Journal of Medical Virology. 79 (5): 562–572. doi:10.1002/jmv.20853. ISSN 0146-6615.
  5. ↑ Nagato, Toshihiro; Ohkuri, Takayuki; Ohara, Kenzo; Hirata, Yui; Kishibe, Kan; Komabayashi, Yuki; Ueda, Seigo; Takahara, Miki; Kumai, Takumi; Ishibashi, Kei; Kosaka, Akemi; Aoki, Naoko; Oikawa, Kensuke; Uno, Yuji; Akiyama, Naoko; Sado, Masatoshi; Takei, Hidehiro; Celis, Esteban; Harabuchi, Yasuaki; Kobayashi, Hiroya (2017). “Programmed death-ligand 1 and its soluble form are highly expressed in nasal natural killer/T-cell lymphoma: a potential rationale for immunotherapy”. Cancer Immunology, Immunotherapy. 66 (7): 877–890. doi:10.1007/s00262-017-1987-x. ISSN 0340-7004.
  6. ↑ Taube, J. M.; Klein, A.; Brahmer, J. R.; Xu, H.; Pan, X.; Kim, J. H.; Chen, L.; Pardoll, D. M.; Topalian, S. L.; Anders, R. A. (2014). “Association of PD-1, PD-1 Ligands, and Other Features of the Tumor Immune Microenvironment with Response to Anti-PD-1 Therapy”. Clinical Cancer Research. 20 (19): 5064–5074. doi:10.1158/1078-0432.CCR-13-3271. ISSN 1078-0432.
  7. ↑ Harabuchi, Yasuaki; Takahara, Miki; Kishibe, Kan; Moriai, Shigetaka; Nagato, Toshihiro; Ishii, Hideyuki (2009). “Nasal natural killer (NK)/T-cell lymphoma: clinical, histological, virological, and genetic features”. International Journal of Clinical Oncology. 14 (3): 181–190. doi:10.1007/s10147-009-0882-7. ISSN 1341-9625.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]