RESUMEN
RESUMEN: El linfoma extranodal de células T/NK es una neoplasia maligna agresiva que se caracteriza por una destrucción de estructuras de la línea media de la cara como paladar y fosa nasal. Presentamos el caso de un paciente de sexo masculino, 48 años de edad, consumidor de cocaína, que consulta en la Facultad de Odontología de la Universidad de Chile en Septiembre del 2015 por síntomas de disfagia, rinorrea y que presenta al examen clínico un tumor ulcerado que compromete paladar duro y blando, de un mes de evolución. Se confirma diagnóstico de linfoma de células T/NK con una batería de pruebas inmunohistoquímicas. Esta patología, aunque infrecuente, siempre debe ser considerada dentro los diagnósticos diferenciales en tumores ulcerados en esta localización.
ABSTRACT: Extranodal T / NK cell lymphoma is an aggressive malignant neoplasm characterized by destruction of midline structures of the face such as the palate and nasal fossa. We present the case of a male patient, 48 years old, cocaine user, who consults at the Faculty of Dentistry of the Universidad de Chile in September of 2015 due to symptoms of dysphagia, rhinorrhea and presenting to the clinical examination an ulcerated tumor which compromises hard and soft palate, a month of evolution. Diagnosis of T / NK cell lymphoma is confirmed with a battery of immunohistochemical tests. This pathology, although infrequent, should always be considered within the differential diagnoses in ulcerated tumors of this location.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Infecciones por Virus de Epstein-Barr/virología , Linfoma Extranodal de Células NK-T/diagnóstico , Linfoma Extranodal de Células NK-T/patología , Células T Asesinas Naturales/patología , Células Asesinas Naturales/virología , Tomografía Computarizada por Rayos X/métodos , Chile , Infecciones por Virus de Epstein-Barr/patología , Linfoma Extranodal de Células NK-T/virologíaRESUMEN
Herein, we report a case of nasal natural killer T-cell lymphoma (NKTL) with intraocular involvement. A 57-year-old woman was referred due to a three-day history of photophobia and diplopia in the left eye. One-month previously, she was diagnosed with nasal NKTL of the right nasal cavity. Ophthalmic examination revealed conjunctival injection and ptosis. The left pupil was fully dilated and non-reactive to light. Ocular motion was restricted on left-upper gaze. Five days later, anterior uveitis developed and persisted despite topical steroid treatment. An orbital magnetic resonance imaging was without specific findings, however, ophthalmoplegia, vitreous opacity, and an iris mass were observed. A diagnostic anterior chamber aspiration was performed. Aqueous humor aspiration revealed 35% morphologically atypical lymphocytes. After an intravitreal triamcinolone injection, radiotherapy and chemotherapy were administered; this resolved the uveitis and iris mass. When refractory uveitis or orbital pseudotumor occurs in patients with nasal NKTL, ocular and orbital involvement of the NKTL should be considered.