Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2018; 6(13): 694-702
Published online Nov 6, 2018. doi: 10.12998/wjcc.v6.i13.694
Natural killer/T-cell lymphoma with concomitant syndrome of inappropriate antidiuretic hormone secretion: A case report and review of literature
Quan-Bo Liu, Rui Zheng
Quan-Bo Liu, Rui Zheng, Department of Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Zheng R and Liu QB designed the report; Liu QB collected the patient’s clinical data and wrote the paper.
Informed consent statement: The patient was not required to give informed consent to the study because the analysis used anonymous data that were obtained after the patient gave written consent for treatment.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rui Zheng, MD, PhD, Doctor, Professor, Teacher, Department of Respiratory Medicine, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. zhengr@sj-hospital.org
Telephone: +86-2496-61521211 Fax: +86-2496-61572116
Received: July 31, 2018
Peer-review started: July 31, 2018
First decision: August 31, 2018
Revised: October 3, 2018
Accepted: October 11, 2018
Article in press: October 11, 2018
Published online: November 6, 2018
Processing time: 98 Days and 5.5 Hours
Abstract

We report a case of natural killer (NK)/T-cell lymphoma with concomitant syndrome of inappropriate antidiuretic hormone secretion (SIADH). The patient was a 64-year-old woman with a history of nasopharyngeal carcinoma of over 30 years. She was admitted with a chief complaint of intermittent fever for 2 mo. Palpation after admission indicated a swollen lymph node below the left jaw. Multiple imaging examinations on admission indicated multiple enlarged lymph nodes throughout the body. We performed a left submandibular lymph node biopsy, and the results revealed NK/T-cell lymphoma. A biochemical examination indicated Epstein-Barr virus positivity. At the same time, the patient developed hyponatremia. Based on her laboratory examination and clinical manifestation, decreased plasma osmolality, urine osmolality greater than plasma osmolality, lack of skin swelling, normal blood pressure, normal renal function, no adrenal function detected on serology, and no abnormalities in imaging examination of the adrenal glands, the likelihood of SIADH in the patient was high. After fluid restriction and administration of sodium chloride, the patient’s blood sodium level gradually increased. Subsequently, the immune function of the patient declined, there were severe symptoms of infection, and she died of respiratory failure. NK/T-cell lymphoma associated with SIADH has not, to our knowledge, been previously reported in PubMed. This case emphasizes the importance of monitoring serum ion levels, especially serum sodium, in patients with NK/T-cell lymphoma.

Keywords: Epstein-Barr virus; Case report; Literature review; Syndrome of inappropriate antidiuretic hormone secretion; Natural killer/T-cell lymphoma

Core tip: Lymphoma is known to be a cause of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Moreover, Epstein-Barr virus (EBV) has a high infection rate, and in very rare cases, it can lead to extranodal natural killer (NK)/T-cell lymphoma. A very limited number of patients with lymphoma accompanied by SIADH have been reported, but NK/T-cell lymphoma with concomitant SIADH has not yet been reported in PubMed. Here, we present a case of NK/T-cell lymphoma in a 64-year-old woman with EBV infection accompanied by SIADH, suggesting the importance of monitoring serum ions, especially serum sodium, in patients with NK/T-cell lymphoma.