Primary duodenal NK/T-cell lymphoma with massive bleeding: A case report

Figure 1 Abdominal computed tomography scan and ultrasonography examination revealed a cavitary mass between the distal jejunum and proximal ileum with multiple enlarged retroperitoneal lymph nodes. A: Plain computed tomography (CT) scan image; B: CT image in the arterial phase of contrast enhancement; C: CT image in the parenchymal phase of contrast enhancement; D: Ultrasonography image.

Figure 2 Images of the emergency endoscopy. The endoscopy showed an irregular ulcer with mucosal edema, destruction, necrosis, a hyperplastic nodule and active bleeding in the duodenal posterior wall.

Figure 3 Photomicrograph of biopsy specimens. A: A large numbers of atypical cells infiltrated the mucosa and mucosal glands became widely spaced or lost [hematoxylin and eosin (HE) stain , × 100]; B: The tumor was composed of medium-sized cells (HE stain, × 400); C: The large cells admixed with small cells (HE stain, × 400); D: Coagulative necrosis and admixed apoptotic bodies were observed in the specimens (HE stain, × 400).

Figure 4 Immunohistochemical characteristics of tumor cells. A: Neoplastic cells showed strong staining for cytoplasmic CD3; B: Positive membranous staining for CD56; C: Strong granular staining for TIA1; D: Negative staining for CD23; E: Negative staining for CD20; F: In situ hybridization showed marked nuclear labeling of EBER. EBER: Epstein-Barr virus encoded small nuclear RNA.