AIM To provide the overall spectrum of gastrosplenic fistula(GSF) occurring in lymphomas through a systematic review including a patient at our hospital.METHODS A comprehensive literature search was performed in the M...AIM To provide the overall spectrum of gastrosplenic fistula(GSF) occurring in lymphomas through a systematic review including a patient at our hospital.METHODS A comprehensive literature search was performed in the MEDLINE database to identify studies of GSF occurring in lymphomas. A computerized search of our institutional database was also performed. In all cases, we analyzed the clinicopathologic/radiologic features, treatment and outcome of GSF occurring in lymphomas. RESULTS A literature search identified 25 relevant studies with 26 patients. Our institutional data search added 1 patient. Systematic review of the total 27 cases revealed that GSF occurred mainly in diffuse, large B-cell lymphoma(n = 23), but also in diffuse, histiocytic lymphoma(n = 1), Hodgkin's lymphoma(n = 2), and NK/T-cell lymphoma(n = 1, our patient). The common clinical presentations are constitutional symptoms(n = 20) and abdominal pain(n = 17), although acute gastrointestinal bleeding(n = 6) and infection symptoms due to splenic abscess(n = 3) are also noted. In all patients, computed tomography scanning was very helpful for diagnosing GSF and for evaluating the lymphoma extent. GSF could occur either post-chemotherapy(n = 10) or spontaneously(n = 17). Surgical resection has been the most common treatment. Once patients have recovered from the acute illness status after undergoing surgery, their long-term outcome has been favorable. CONCLUSION This systematic review provides an overview of GSF occurring in lymphomas, and will be helpful in making physicians aware of this rare disease entity.展开更多
Background:Nasal-type extranodal natural killer/T-cell lymphoma(ENKTCL) originates primarily in the nasal cavity or extra-nasal sites within the upper aerodigestive tract.However,it is unclear whether the primary site...Background:Nasal-type extranodal natural killer/T-cell lymphoma(ENKTCL) originates primarily in the nasal cavity or extra-nasal sites within the upper aerodigestive tract.However,it is unclear whether the primary site can serve as an independent prognostic factor or whether the varying clinical outcomes observed with different primary sites can be attributed merely to their propensities of regional lymph node involvement.The aim of this study was to investigate the prognostic implications of the primary site and regional lymph node involvement in patients with early-stage nasal-type ENKTCL.Methods:To develop a nomogram,we reviewed the clinical data of 215 consecutively diagnosed patients with early-stage nasal-type ENKTCL who were treated in Sun Yat-sen University Cancer Center with chemotherapy and radiotherapy between 2000 and 2011.The predictive accuracy and discriminative ability of the nomogram were determined using a concordance index(C-index) and calibration curve.Results:The 5-year overall survival(OS) and progression-free survival(PFS) rates of patients with nasal ENKTCL were higher than those of patients with extra-nasal ENKTCL(OS:68.2%vs.46.0%,P = 0.030;PFS:53.4%vs.26.6%,P = 0.010).The 5-year OS and PFS rates of patients with Ann Arbor stage IE ENKTCL were higher than those of patients with Ann Arbor stage HE ENKTCL(OS:66.3%vs.59.2%,P = 0.003;PFS:51.4%vs.40.3%,P = 0.009).Multivariate analysis showed that age >60 years,ECOG performance status score >2,elevated lactate dehydrogenase(LDH) level,extranasal primary site,and regional lymph node involvement were significantly associated with lower 5-year OS rate;age >60 years,elevated LDH level,extra-nasal primary site,and regional lymph node involvement were significantly associated with lower 5-year PFS rate.The nomogram included the primary site and regional lymph node involvement based on multivariate analysis.The calibration curve showed good agreement between the predicted and actual 5-year OS and PFS rates,and the C-indexes of the nomogram for the OS and PFS rates were 0.697 and 0.634,respectively.Conclusions:The primary site and regional lymph node involvement are independent prognostic factors for earlystage ENKTCL treated with chemotherapy followed by definitive radiotherapy.展开更多
Extranodal natural killer/T-cell lymphoma(ENKTL) is a distinct subtype of non-Hodgkin's lymphoma and is rare in the colon.Synchronous adenocarcinoma and ENKTL of the colon has not been reported in the literature.I...Extranodal natural killer/T-cell lymphoma(ENKTL) is a distinct subtype of non-Hodgkin's lymphoma and is rare in the colon.Synchronous adenocarcinoma and ENKTL of the colon has not been reported in the literature.In the present study,we report a 63-year-old male who suffered from intermittent bloody stools for 2 mo.He did not have fever,body weight loss or night sweat.Endoscopic and imaging studies revealed a 4.5-cm ulcerative mass in the ascending colon and a 3.0-cm polypoid,easy bleeding mass in the sigmoid colon,respectively.Thought to have double carcinoma of the colon,he received simultaneous right hemicolectomy and sigmoidectomy.The pathological diagnosis was a synchronous ENKTL(ascending colon) and adenocarcinoma(sigmoid colon).The literature on synchronous adenocarcinoma and malignant lymphoma of the colon was also reviewed.展开更多
Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Metho...Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.展开更多
BACKGROUND Natural killer(NK)/T cell lymphoma is a rare and highly aggressive malignant tumor,and is a special form of non-Hodgkin's lymphoma.Although extranodal involvement is frequently found in tissues such as ...BACKGROUND Natural killer(NK)/T cell lymphoma is a rare and highly aggressive malignant tumor,and is a special form of non-Hodgkin's lymphoma.Although extranodal involvement is frequently found in tissues such as the skin,testicular and gastrointestinal tract etc,its presence in skeletal muscle has scarcely been reported in the literature.CASE SUMMARY We report a case of extranodal NK/T cell lymphoma with muscle swelling as the first clinical manifestation.A 42-year-old man,who initially presented with localized swelling in the double lower extremities,demonstrated gradual facial and eyelid swelling,and his imaging results showed multiple sites of muscle damage throughout the body.The final pathological results suggested NK/T cell lymphoma,and immunohistochemistry showed CD20(-),CD3(+),CD30(+),CD56(-),EBER(+),Ki67(60%),TIA-1(+)and CD68(±)staining.The muscle swelling significantly improved after treatment with chemotherapy regimens.CONCLUSION This disease is difficult to diagnose and highly invasive,and should be included in the differential diagnosis of unexplained muscle swelling.展开更多
BACKGROUND Extranodal natural killer(NK) T-cell lymphoma(ENKTL), nasal type is a rare subtype of extranodal non-Hodgkin lymphoma characterized by vascular damage and necrosis. The lesions usually present in the nasal ...BACKGROUND Extranodal natural killer(NK) T-cell lymphoma(ENKTL), nasal type is a rare subtype of extranodal non-Hodgkin lymphoma characterized by vascular damage and necrosis. The lesions usually present in the nasal cavity and adjacent tissues, however, the disease originates from the gastrointestinal or genitourinary tract in 25% of cases. Since rectal involvement in ENKTL is rare, rectal symptoms in the course of ENKTL are often misdiagnosed and considered to be related to benign diseases such as rectal fistula or perianal abscess.CASE SUMMARY We report the case of a 24-year-old Han Chinese female who initially presented with a perianal abscess that was subsequently diagnosed as nasal type ENKTL.Due to typical perianal pain, perianal abscess was diagnosed and surgical incision and drainage were performed. After recurrent, severe anal hemorrhages leading to hypovolemic shock and multiple surgeries, a diagnosis of ENKTL was made. The patient's condition gradually deteriorated, and she died shortly after initiation of chemotherapy.CONCLUSION Systemic and neoplastic diseases should be included in the differential diagnosis of any potentially benign perianal abscess complicated with recurrent hemorrhages.展开更多
Background:The prognostic significance of ABO blood type for lymphoma is largely unknown.We evaluated the prognostic role of ABO blood type in patients with extranodal natural killer(NK)/T-cell lymphoma(ENKTL).Methods...Background:The prognostic significance of ABO blood type for lymphoma is largely unknown.We evaluated the prognostic role of ABO blood type in patients with extranodal natural killer(NK)/T-cell lymphoma(ENKTL).Methods:We retrospectively analyzed clinical data of 697 patients with newly diagnosed ENKTL from three cancer centers.The prognostic value of ABO blood type was evaluated using Kaplan-Meier curves and Cox proportional hazard models.The prognostic values of the International Prognostic Index(IPI) and the Korean Prognostic Index(KPI)were also evaluated.Results:Compared with patients with blood type O,those with blood type non-O tended to display elevated baseline serum C-reactive protein levels(P=0.038),lower rate of complete remission(P=0.005),shorter progression-free survival(PFS,P<0.001),and shorter overall survival(OS,P=0.001).Patients with blood type O/AB had longer PFS(P<0.001) and OS(P=0.001) compared with those with blood type A/B.Multivariate analysis demonstrated that age >60 years(P<0.001),mass ≥5 cm(P=0.001),stage Ⅲ/Ⅳ(P<0.001),elevated serum lactate dehydrogenase(LDH) levels(P=0.001),and blood type non-O were independent adverse predictors of OS(P=0.001).ABO blood type was found to be superior to both the IPI in discriminating patients with different outcomes in the IPI low-risk group and the KPI in distinguishing between the intermediate-to-low-and high-to-intermediate-risk groups.Conclusions:ABO blood type was an independent predictor of clinical outcome for patients with ENKTL.展开更多
结外鼻型NK/T细胞淋巴瘤(extranodal nasal type NK/T-cell lymphoma,ENKTL)是一种以破坏面部中份结构为主的NK/T细胞来源的非霍奇金淋巴瘤,临床少见。以口腔黏膜溃疡为首发症状的病例罕见且易与其他疾病相混淆,在诊断上极其困难。本文...结外鼻型NK/T细胞淋巴瘤(extranodal nasal type NK/T-cell lymphoma,ENKTL)是一种以破坏面部中份结构为主的NK/T细胞来源的非霍奇金淋巴瘤,临床少见。以口腔黏膜溃疡为首发症状的病例罕见且易与其他疾病相混淆,在诊断上极其困难。本文报道1例以颊黏膜及牙龈溃疡为首发表现的ENKTL的多学科诊疗,并分析该疾病的临床病理学特征、诊断、鉴别诊断和治疗,以期为临床诊治相关病例提供参考。展开更多
BACKGROUND Primary intestinal extranodal natural killer/T-cell lymphoma,nasal type(PIENKTCL)is a rare non-Hodgkin’s lymphoma(NHL)subtype,and its prognosis is extremely poor.Clinical characteristics of the disease are...BACKGROUND Primary intestinal extranodal natural killer/T-cell lymphoma,nasal type(PIENKTCL)is a rare non-Hodgkin’s lymphoma(NHL)subtype,and its prognosis is extremely poor.Clinical characteristics of the disease are not obvious and easily misdiagnosed.In this case report,we describe a patient with PI-ENKTCL who presented with intermittent hematochezia.The advantages of positron emission tomography/computed tomography(PET-CT)as a useful diagnostic tool and the role of surgery as an important therapy are highlighted.CASE SUMMARY A 45-year-old man,hospitalized due to intermittent hematochezia,underwent gastroscopy,colonoscopy,biopsy and CT,but no cause was found.Hence,we carried out a multidisciplinary team(MDT)discussion on the causes and treatment of this patient,and it was decided to perform PET-CT imaging with a MDT discussion of the results.PET-CT demonstrated a diagnosis of lymphoma and it was decided to surgically resect the lesion,and a R0 resection was successfully performed.Postoperative pathology showed negative resection margins,and examination of the lesion confirmed the diagnosis of PI-ENKTCL.After surgery,the patient underwent a follow-up period of 6 mo and received 6 cycles of gemcitabine,oxaliplatin and L-asparaginase.No recurrence or metastasis occurred.CONCLUSION PI-ENKTCL is rare,and MDT discussion is required during diagnosis.PET-CT can be performed for imaging diagnosis.Treatment is based on surgical resection,and the best treatment regimen is determined according to postoperative pathological results to improve prognosis and to extend survival in patients.展开更多
文摘AIM To provide the overall spectrum of gastrosplenic fistula(GSF) occurring in lymphomas through a systematic review including a patient at our hospital.METHODS A comprehensive literature search was performed in the MEDLINE database to identify studies of GSF occurring in lymphomas. A computerized search of our institutional database was also performed. In all cases, we analyzed the clinicopathologic/radiologic features, treatment and outcome of GSF occurring in lymphomas. RESULTS A literature search identified 25 relevant studies with 26 patients. Our institutional data search added 1 patient. Systematic review of the total 27 cases revealed that GSF occurred mainly in diffuse, large B-cell lymphoma(n = 23), but also in diffuse, histiocytic lymphoma(n = 1), Hodgkin's lymphoma(n = 2), and NK/T-cell lymphoma(n = 1, our patient). The common clinical presentations are constitutional symptoms(n = 20) and abdominal pain(n = 17), although acute gastrointestinal bleeding(n = 6) and infection symptoms due to splenic abscess(n = 3) are also noted. In all patients, computed tomography scanning was very helpful for diagnosing GSF and for evaluating the lymphoma extent. GSF could occur either post-chemotherapy(n = 10) or spontaneously(n = 17). Surgical resection has been the most common treatment. Once patients have recovered from the acute illness status after undergoing surgery, their long-term outcome has been favorable. CONCLUSION This systematic review provides an overview of GSF occurring in lymphomas, and will be helpful in making physicians aware of this rare disease entity.
文摘Background:Nasal-type extranodal natural killer/T-cell lymphoma(ENKTCL) originates primarily in the nasal cavity or extra-nasal sites within the upper aerodigestive tract.However,it is unclear whether the primary site can serve as an independent prognostic factor or whether the varying clinical outcomes observed with different primary sites can be attributed merely to their propensities of regional lymph node involvement.The aim of this study was to investigate the prognostic implications of the primary site and regional lymph node involvement in patients with early-stage nasal-type ENKTCL.Methods:To develop a nomogram,we reviewed the clinical data of 215 consecutively diagnosed patients with early-stage nasal-type ENKTCL who were treated in Sun Yat-sen University Cancer Center with chemotherapy and radiotherapy between 2000 and 2011.The predictive accuracy and discriminative ability of the nomogram were determined using a concordance index(C-index) and calibration curve.Results:The 5-year overall survival(OS) and progression-free survival(PFS) rates of patients with nasal ENKTCL were higher than those of patients with extra-nasal ENKTCL(OS:68.2%vs.46.0%,P = 0.030;PFS:53.4%vs.26.6%,P = 0.010).The 5-year OS and PFS rates of patients with Ann Arbor stage IE ENKTCL were higher than those of patients with Ann Arbor stage HE ENKTCL(OS:66.3%vs.59.2%,P = 0.003;PFS:51.4%vs.40.3%,P = 0.009).Multivariate analysis showed that age >60 years,ECOG performance status score >2,elevated lactate dehydrogenase(LDH) level,extranasal primary site,and regional lymph node involvement were significantly associated with lower 5-year OS rate;age >60 years,elevated LDH level,extra-nasal primary site,and regional lymph node involvement were significantly associated with lower 5-year PFS rate.The nomogram included the primary site and regional lymph node involvement based on multivariate analysis.The calibration curve showed good agreement between the predicted and actual 5-year OS and PFS rates,and the C-indexes of the nomogram for the OS and PFS rates were 0.697 and 0.634,respectively.Conclusions:The primary site and regional lymph node involvement are independent prognostic factors for earlystage ENKTCL treated with chemotherapy followed by definitive radiotherapy.
基金Supported by The Buddhist Dalin Tzu-Chi General Hospital
文摘Extranodal natural killer/T-cell lymphoma(ENKTL) is a distinct subtype of non-Hodgkin's lymphoma and is rare in the colon.Synchronous adenocarcinoma and ENKTL of the colon has not been reported in the literature.In the present study,we report a 63-year-old male who suffered from intermittent bloody stools for 2 mo.He did not have fever,body weight loss or night sweat.Endoscopic and imaging studies revealed a 4.5-cm ulcerative mass in the ascending colon and a 3.0-cm polypoid,easy bleeding mass in the sigmoid colon,respectively.Thought to have double carcinoma of the colon,he received simultaneous right hemicolectomy and sigmoidectomy.The pathological diagnosis was a synchronous ENKTL(ascending colon) and adenocarcinoma(sigmoid colon).The literature on synchronous adenocarcinoma and malignant lymphoma of the colon was also reviewed.
基金Supported by a grant from the Sichuan Health and Family Planning Commission(No.16PJ041)
文摘Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.
基金Supported by the National Natural Science Foundation of China,No.81400978
文摘BACKGROUND Natural killer(NK)/T cell lymphoma is a rare and highly aggressive malignant tumor,and is a special form of non-Hodgkin's lymphoma.Although extranodal involvement is frequently found in tissues such as the skin,testicular and gastrointestinal tract etc,its presence in skeletal muscle has scarcely been reported in the literature.CASE SUMMARY We report a case of extranodal NK/T cell lymphoma with muscle swelling as the first clinical manifestation.A 42-year-old man,who initially presented with localized swelling in the double lower extremities,demonstrated gradual facial and eyelid swelling,and his imaging results showed multiple sites of muscle damage throughout the body.The final pathological results suggested NK/T cell lymphoma,and immunohistochemistry showed CD20(-),CD3(+),CD30(+),CD56(-),EBER(+),Ki67(60%),TIA-1(+)and CD68(±)staining.The muscle swelling significantly improved after treatment with chemotherapy regimens.CONCLUSION This disease is difficult to diagnose and highly invasive,and should be included in the differential diagnosis of unexplained muscle swelling.
基金Supported by the Nanjing Health Bureau Project,No.ZKX17034Nanjing Traditional Chinese Medicine of Medical Conversion Base,No.ZHZD201802The 13~(th) Five-Year Plan for Training Young Health Personnel in Nanjing,No.NWQR-201702
文摘BACKGROUND Extranodal natural killer(NK) T-cell lymphoma(ENKTL), nasal type is a rare subtype of extranodal non-Hodgkin lymphoma characterized by vascular damage and necrosis. The lesions usually present in the nasal cavity and adjacent tissues, however, the disease originates from the gastrointestinal or genitourinary tract in 25% of cases. Since rectal involvement in ENKTL is rare, rectal symptoms in the course of ENKTL are often misdiagnosed and considered to be related to benign diseases such as rectal fistula or perianal abscess.CASE SUMMARY We report the case of a 24-year-old Han Chinese female who initially presented with a perianal abscess that was subsequently diagnosed as nasal type ENKTL.Due to typical perianal pain, perianal abscess was diagnosed and surgical incision and drainage were performed. After recurrent, severe anal hemorrhages leading to hypovolemic shock and multiple surgeries, a diagnosis of ENKTL was made. The patient's condition gradually deteriorated, and she died shortly after initiation of chemotherapy.CONCLUSION Systemic and neoplastic diseases should be included in the differential diagnosis of any potentially benign perianal abscess complicated with recurrent hemorrhages.
基金supported by the grants from the Hunan Provincial Science and Technology Department(No.2016JJ3083)the grants from the Heath and Family Planning Commission of Hunan Province(No.c2015-52)
文摘Background:The prognostic significance of ABO blood type for lymphoma is largely unknown.We evaluated the prognostic role of ABO blood type in patients with extranodal natural killer(NK)/T-cell lymphoma(ENKTL).Methods:We retrospectively analyzed clinical data of 697 patients with newly diagnosed ENKTL from three cancer centers.The prognostic value of ABO blood type was evaluated using Kaplan-Meier curves and Cox proportional hazard models.The prognostic values of the International Prognostic Index(IPI) and the Korean Prognostic Index(KPI)were also evaluated.Results:Compared with patients with blood type O,those with blood type non-O tended to display elevated baseline serum C-reactive protein levels(P=0.038),lower rate of complete remission(P=0.005),shorter progression-free survival(PFS,P<0.001),and shorter overall survival(OS,P=0.001).Patients with blood type O/AB had longer PFS(P<0.001) and OS(P=0.001) compared with those with blood type A/B.Multivariate analysis demonstrated that age >60 years(P<0.001),mass ≥5 cm(P=0.001),stage Ⅲ/Ⅳ(P<0.001),elevated serum lactate dehydrogenase(LDH) levels(P=0.001),and blood type non-O were independent adverse predictors of OS(P=0.001).ABO blood type was found to be superior to both the IPI in discriminating patients with different outcomes in the IPI low-risk group and the KPI in distinguishing between the intermediate-to-low-and high-to-intermediate-risk groups.Conclusions:ABO blood type was an independent predictor of clinical outcome for patients with ENKTL.
文摘结外鼻型NK/T细胞淋巴瘤(extranodal nasal type NK/T-cell lymphoma,ENKTL)是一种以破坏面部中份结构为主的NK/T细胞来源的非霍奇金淋巴瘤,临床少见。以口腔黏膜溃疡为首发症状的病例罕见且易与其他疾病相混淆,在诊断上极其困难。本文报道1例以颊黏膜及牙龈溃疡为首发表现的ENKTL的多学科诊疗,并分析该疾病的临床病理学特征、诊断、鉴别诊断和治疗,以期为临床诊治相关病例提供参考。
基金Supported by National Natural Science Foundation of China,No.81260326 and No.81660398Natural Science Foundation of Gansu Province,No.17JR5RA034
文摘BACKGROUND Primary intestinal extranodal natural killer/T-cell lymphoma,nasal type(PIENKTCL)is a rare non-Hodgkin’s lymphoma(NHL)subtype,and its prognosis is extremely poor.Clinical characteristics of the disease are not obvious and easily misdiagnosed.In this case report,we describe a patient with PI-ENKTCL who presented with intermittent hematochezia.The advantages of positron emission tomography/computed tomography(PET-CT)as a useful diagnostic tool and the role of surgery as an important therapy are highlighted.CASE SUMMARY A 45-year-old man,hospitalized due to intermittent hematochezia,underwent gastroscopy,colonoscopy,biopsy and CT,but no cause was found.Hence,we carried out a multidisciplinary team(MDT)discussion on the causes and treatment of this patient,and it was decided to perform PET-CT imaging with a MDT discussion of the results.PET-CT demonstrated a diagnosis of lymphoma and it was decided to surgically resect the lesion,and a R0 resection was successfully performed.Postoperative pathology showed negative resection margins,and examination of the lesion confirmed the diagnosis of PI-ENKTCL.After surgery,the patient underwent a follow-up period of 6 mo and received 6 cycles of gemcitabine,oxaliplatin and L-asparaginase.No recurrence or metastasis occurred.CONCLUSION PI-ENKTCL is rare,and MDT discussion is required during diagnosis.PET-CT can be performed for imaging diagnosis.Treatment is based on surgical resection,and the best treatment regimen is determined according to postoperative pathological results to improve prognosis and to extend survival in patients.