中溝　宗永    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor (Fixed Term)
Article types	Case report
Language	English
Peer review	Peer reviewed
Title	Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type, with Primary Manifestation as an Upper Eyelid Swelling.
Journal	Formal name：Journal of Nippon Medical School = Nippon Ika Daigaku zasshi Abbreviation：J Nippon Med Sch ISSN code：13473409/13454676
Domestic / Foregin	Foregin
Volume, Issue, Page	83(4),pp.177-179
Author and coauthor	Kanzaki Akiko, Funasaka Yoko, Nakamizo Munenaga, Shima Ayaka, Ryotokuji Takeshi, Dan Kazuo, Terasaki Mika, Sugisaki Yuichi, Fukuda Yu, Kawana Seiji, Saeki Hidehisa
Publication date	2016
Summary	Extranodal natural killer/T-cell lymphoma (ENK/TCL) is most often in the nose or the nasopharynx but can present elsewhere. We report a rare case of ENK/TCL that presented as swelling of an upper eyelid without ocular involvement. A 76-year-old man visited our hospital with a swollen lesion of the left upper eyelid which had appeared 2 months earlier. A biopsy of the upper eyelid revealed slight perivascular and periadnexal infiltration of mononuclear cells with dermal edema. Treatment with oral prednisolone at a dosage of 20 mg/day decreased the eyelid swelling. However, 5 months later, exacerbation of the swelling and nasal congestion were observed. A second biopsy of the upper eyelid revealed a diffuse dermal infiltrate composed of mononuclear cells with an angiocentic growth pattern. Immunohistochemical studies and in situ hybridization showed natural killer-lineage antigens (CD56, granzyme B, and T-cell intracellular antigen 1) with expression of Epstein-Barr virus. These findings lead to the diagnosis of ENK/TCL. We treated the patient with radiation therapy (50 Gy) and 3 courses of a regimen including dexamethasone, carboplatin, etoposide, and ifosphamide. This case suggests that ENK/TCL can present with swelling of an upper eyelid as the primary sign of the skin lesion. Swelling of an upper eyelid should be considered in the differential diagnosis of ENK/TCL.
DOI	10.1272/jnms.83.177
PMID	27680487