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Clinical Problem Solving: Pathology
November 2002

Diagnosis Pathology Quiz Case 2

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Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2002

Arch Otolaryngol Head Neck Surg. 2002;128(11):1328-1329. doi:

The specimen showed a dense lymphoid infiltrate in the submucosa that was composed of large and medium-sized malignant lymphoid cells with vesicular nuclei and variable-sized nucleoli (Figure 2A and B). There was some individual cell necrosis. Angiocentricity, a common but not constant finding in NK/T-cell lymphoma, is not obvious in the specimen. Immunophenotyping by flow cytometry showed that the cells expressed CD2 and CD56 antigens but not CD3, CD5, CD7, CD4, or CD8. Immunohistochemical staining demonstrated cytoplasmic CD3 (Figure 2D). The B-cell–associated antigen CD20 was not expressed. In situ hybridization studies showed that the Epstein-Barr virus–associated RNA transcript, EBER-1, was positive in the majority of neoplastic cells (Figure 2C). These immunophenotypic findings are typical of NK/T-cell extranodal lymphomas of the nasal type.1

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