Diagnosis of primary meningeal natural killer/T‑cell lymphoma of the central nervous system using cerebrospinal fluid cytology: A case report

Chen,Xiaoli; Feng,Jin; Zhang,Weihua; Min,Zhiqian; Zhao,Shuqi

doi:10.3892/ol.2024.14859

Diagnosis of primary meningeal natural killer/T‑cell lymphoma of the central nervous system using cerebrospinal fluid cytology: A case report

Authors:
- Xiaoli Chen
- Jin Feng
- Weihua Zhang
- Zhiqian Min
- Shuqi Zhao
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Affiliations: Department of Neurology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710000, P.R. China, Department of Clinical Laboratory Diagnostics, Xi'an Medical University, Xi'an, Shaanxi 710068, P.R. China, Department of Hematology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710000, P.R. China, Department of Radiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710000, P.R. China, Institute of Hematological Research, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710000, P.R. China
Published online on: December 31, 2024 https://doi.org/10.3892/ol.2024.14859
Article Number: 113
Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Primary central nervous system (CNS) lymphoma of the meninges is a rare tumor that originates in the meninges and does not show parenchymal or systemic spread. CNS involvement by natural killer (NK)/T‑cell lymphoma accounts for only 2% of all extranodal NK/T‑cell lymphomas, and primary NK/T‑cell lymphoma of the meninges is even rarer. The present study reports a case of a 55‑year‑old male patient with primary NK/T‑cell lymphoma. The patient presented with intermittent dizziness and headaches for the past 1 month prior to presentation. Magnetic resonance imaging of the head identified no overt abnormalities. However, cytological analysis of a Wright‑Giemsa‑stained cerebrospinal fluid (CSF) sample, demonstrated numerous atypical lymphocytes and lymphoma cells. Flow cytometry of the CSF was performed as an auxiliary method, and it showed that a large proportion of the cells in the CSF were of the NK/T‑cell lineage, to indicating a diagnosis of NK/T‑cell lymphoma. Mutations of 14 genes were detected, including JAK3 mutations, upon screening of the CSF for blood system diseases using next‑generation sequencing. Therefore, the present study demonstrated that a CSF cytological examination may be an important component of the diagnostic workup for patients suspected to have a primary meningeal CNS lymphoma.

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1	Shah T and Venur VA: Central nervous system lymphoma. Semin Neurol. 43:825–832. 2023. View Article : Google Scholar : PubMed/NCBI
2	Hernández-Verdin I, Morales-Martínez A, Hoang-Xuan K and Alentorn A: Primary central nervous system lymphoma: Advances in its pathogenesis, molecular markers and targeted therapies. Curr Opin Neurol. 35:779–786. 2022. View Article : Google Scholar : PubMed/NCBI
3	Hoang-Xuan K, Deckert M, Ferreri AJM, Furtner J, Gallego Perez-Larraya J, Henriksson R, Hottinger AF, Kasenda B, Lefranc F, Lossos A, et al: European association of neuro-oncology (EANO) guidelines for treatment of primary central nervous system lymphoma (PCNSL). Neuro Oncol. 25:37–53. 2023. View Article : Google Scholar : PubMed/NCBI
4	Liao B, Kamiya-Matsuoka C, Gong Y, Chen M, Wolf BA and Fowler NH: Primary natural killer/T-cell lymphoma presenting as leptomeningeal disease. J Neurol Sci. 343:46–50. 2014. View Article : Google Scholar : PubMed/NCBI
5	Chen X, Huang M, Zhang Z, Jing H, Zou Y and Bu H: Primary meningeal central nervous system lymphoma: A case report and literature review. Medicine (Baltimore). 101:e325672022. View Article : Google Scholar : PubMed/NCBI
6	Pietras NM, Gupta N, Justiz Vaillant AA and Pearson-Shaver AL: Immune thrombocytopenia. StatPearls [Internet] Treasure Island (FL): StatPearls Publishing; 2024
7	Guo Y, Liu X, Zihao Z, Zhang Q, Shi Z and Zhang N: Blood routine reference value range should be adjusted according to regional and ethnic characteristics. Front Public Health. 10:9341012022. View Article : Google Scholar : PubMed/NCBI
8	Sabattini E, Bacci F, Sagramoso C and Pileri SA: WHO classification of tumours of haematopoietic and lymphoid tissues in 2008: An overview. Pathologica. 102:83–87. 2010.PubMed/NCBI
9	Guan H, Huang Y, Wen W, Xu M, Zan Q and Zhang Z: Primary central nervous system extranodal NK/T-cell lymphoma, nasal type: Case report and review of the literature. J Neurooncol. 103:387–391. 2011. View Article : Google Scholar : PubMed/NCBI
10	Li X, Yu H, Fu X, Zhang L, Li X, Li L, Wang X, Sun Z, Zhang X, Li Z, et al: Clinical analysis of patients with primary and secondary extranodal natural killer/T-cell lymphoma of central nervous system. Hematol Oncol. 41:267–274. 2023. View Article : Google Scholar : PubMed/NCBI
11	Küker W, Nägele T, Korfel A, Heckl S, Thiel E, Bamberg M, Weller M and Herrlinger U: Primary central nervous system lymphomas (PCNSL): MRI features at presentation in 100 patients. J Neurooncol. 72:169–177. 2005. View Article : Google Scholar : PubMed/NCBI
12	Capasso R, Negro A, Russo C, Zeccolini F, Muto G, Caranci F and Prof Pinto A: Conventional and advanced MRI Techniques in the evaluation of primary CNS lymphoma. Semin Ultrasound CT MR. 44:126–135. 2023. View Article : Google Scholar : PubMed/NCBI
13	Zing NF, Thais F, Massimo C, Chiattone C and Ferreri AJM: Diagnosis, prevention and treatment of central nervous system involvement in peripheral t-cell lymphomas. Crit Rev Oncol Hematol. 167:1034962021. View Article : Google Scholar : PubMed/NCBI
14	Kleinschmidt-DeMasters BK and Gilani A: Secondary parenchymal CNS involvement by lymphoma including rare types: Follicular and EBV-positive NK/T cell lymphoma, nasal type. Ann Diagn Pathol. 53:1517652021. View Article : Google Scholar : PubMed/NCBI
15	Kajtazi NI, Bafaquh M, Ghamdi JA, AlEissa Z, Shmeikh AA, Alsaeed A, Sulaiman T, Vizcaino MA, Al Hameed M and Raghunathan A: An unusual case of EBV-negative primary CNS lymphoma of natural killer/T-cell lineage. Clin Pathol. 14:2632010X2110656922021. View Article : Google Scholar : PubMed/NCBI
16	Ball MK, Morris JM, Wood AJ, Meyer FB, Kaszuba MC and Raghunathan A: Ventricle-predominant primary CNS lymphomas: Clinical, radiological and pathological evaluation of five cases and review of the literature. Brain Tumor Pathol. 37:22–30. 2020. View Article : Google Scholar : PubMed/NCBI
17	Kan Y, Wang Y, Wang W, Liu J and Yang J: Unexpected corpus callosum involvement of diffuse large B-cell lymphoma on FDG PET/CT. Clin Nucl Med. 43:933–935. 2018. View Article : Google Scholar : PubMed/NCBI
18	Guedes BF and Cury RG: Trigeminal nerve thickening in chronic inflammatory demyelinating polyneuropathy. Arq Neuropsiquiatr. 73:634–635. 2015. View Article : Google Scholar : PubMed/NCBI
19	Nikanjam M, Kato S and Kurzrock R: Liquid biopsy: Current technology and clinical applications. J Hematol Oncol. 15:1312022. View Article : Google Scholar : PubMed/NCBI
20	Liu J, Liang L, Li D, Nong L, Zheng Y, Huang S, Zhang B and Li T: JAK3/STAT3 oncogenic pathway and PRDM1 expression stratify clinicopathologic features of extranodal NK/T-cell lymphoma, nasal type. Oncol Rep. 41:3219–3232. 2019.PubMed/NCBI
21	Koo GC, Tan SY, Tang T, Poon SL, Allen GE, Tan L, Chong SC, Ong WS, Tay K, Tao M, et al: Janus kinase 3-activating mutations identified in natural killer/T-cell lymphoma. Cancer Discov. 2:591–597. 2012. View Article : Google Scholar : PubMed/NCBI
22	Yamaguchi J, Ohka F, Kitano Y, Maeda S, Motomura K, Aoki K, Takeuchi K, Nagata Y, Hattori H, Tsujiuchi T, et al: Rapid detection of the MYD88 L265P mutation for pre- and intra-operative diagnosis of primary central nervous system lymphoma. Cancer Sci. 114:2544–2551. 2023. View Article : Google Scholar : PubMed/NCBI
23	Iriyama C, Murate K, Iba S, Okamoto A, Goto N, Yamamoto H, Kato T, Mihara K, Miyama T, Hattori K, et al: Utility of cerebrospinal fluid liquid biopsy in distinguishing CNS lymphoma from cerebrospinal infectious/demyelinating diseases. Cancer Med. 12:16972–16984. 2023. View Article : Google Scholar : PubMed/NCBI