Case Report
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World J Clin Oncol. Jun 10, 2012; 3(6): 92-97
Published online Jun 10, 2012. doi: 10.5306/wjco.v3.i6.92
Primary duodenal NK/T-cell lymphoma with massive bleeding: A case report
Jian-Zhong Li, Jin Tao, Dan-Yun Ruan, Yi-Dong Yang, Ya-Shi Zhan, Xing Wang, Yu Chen, Si-Chi Kuang, Chun-Kui Shao, Bin Wu
Jian-Zhong Li, Jin Tao, Yi-Dong Yang, Ya-Shi Zhan, Xing Wang, Yu Chen, Bin Wu, Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Dan-Yun Ruan, Department of Oncology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Si-Chi Kuang, Department of Radiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Chun-Kui Shao, Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Author contributions: Li JZ and Tao J contributed equally to this work; Li JZ, Tao J, Ruan DY, Yang YD, Zhan YS, Wang X, Chen Y, Kuang SC, Shao CK and Wu B analyzed the data and diagnosed and treated the patient; Li JZ, Tao J and Wu B wrote the paper.
Supported by The Major Projects Incubator National Natural Science Foundation of China, No. 30971357 and No. 82000-3171310; Guangdong Science and Technology Program, No. 2009B060300001; Program of Sun Yat-Sen University, No. 10ykjc25; and One Hundred Talents Program of Sun Yat-Sen University
Correspondence to: Bin Wu, MD, PhD, Professor, Chairman, Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China. binwu001@hotmail.com
Telephone: +86-20-85253095 Fax: +86-20-85253336
Received: January 23, 2012
Revised: May 12, 2012
Accepted: June 5, 2012
Published online: June 10, 2012
Abstract

Primary natural killer/T-cell (NK/T-cell) lymphoma of the gastrointestinal tract is a very rare disease with a poor prognosis, and the duodenum is quite extraordinary as a primary lesion site. Here, we describe a unique case of a primary duodenal NK/T-cell lymphoma in a 26-year-old man who presented with abdominal pain and weight loss. Abdominal computed tomography scan demonstrated a hypodense tumor in the duodenum. Because of massive upper gastrointestinal tract bleeding during hospitalization, the patient was examined by emergency upper gastrointestinal endoscopy. Under endoscopy, an irregular ulcer with mucosal edema, destruction, necrosis, a hyperplastic nodule and active bleeding was observed on the duodenal posterior wall. Following endoscopic hemostasis, a biopsy was obtained for pathological evaluation. The lesion was subsequently confirmed to be a duodenal NK/T-cell lymphoma. The presenting symptoms of primary duodenal NK-/T-cell lymphoma in this patient were abdominal pain and gastrointestinal bleeding, and endoscopy was important for diagnosis. Despite aggressive treatments, the prognosis was very poor.

Keywords: Bleeding; Duodenum; Natural killer/T-cell lymphoma