A case report of Extranodal natural killer / T-cell lymphoma presenting as extensive myiasis

We described a 56-year-old Indonesian man with one-month history of nasal obstruction and rapidly increasing nasal swelling and two weeks history of severe facial pain with foul smelling discharge, bleeding and noticing live maggots emerging from his nasal and oral cavity. On examination, he appeare...

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Main Authors: Wong, Eugene Hung Chih, Quah, Gabriel Xia Peng, Yong, Doh Jeing
Format: Article
Language:English
English
Published: Elsevier 2022
Subjects:
Online Access:https://eprints.ums.edu.my/id/eprint/33425/3/A%20case%20report%20of%20Extranodal%20natural%20killer.pdf
https://eprints.ums.edu.my/id/eprint/33425/1/A%20case%20report%20of%20Extranodal%20natural%20killer%20_ABSTRACT.pdf
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author Wong, Eugene Hung Chih
Quah, Gabriel Xia Peng
Yong, Doh Jeing
author_facet Wong, Eugene Hung Chih
Quah, Gabriel Xia Peng
Yong, Doh Jeing
author_sort Wong, Eugene Hung Chih
collection UMS
description We described a 56-year-old Indonesian man with one-month history of nasal obstruction and rapidly increasing nasal swelling and two weeks history of severe facial pain with foul smelling discharge, bleeding and noticing live maggots emerging from his nasal and oral cavity. On examination, he appeared cachexic with a markedly swollen, erythematous and deformed external nose. Live maggots, pus and necrotic tissues were found in both nasal cavities, with erosion of upper gingiva and hard palate. Patient was managed initially with tracheostomy under local anaesthesia, followed by removal of around 350 live maggots from the nasal cavities and debridement of necrotic tissues. A midline nasal cavity mass which extended laterally into the nasal cavity was found, along with a large defect over the gingival labial sulcus with necrotic hard palate and a communication between oral and nasal cavities. Biopsies were taken from the nasal mass, gingiva and hard palate. Histopathological results from the biopsies showed diffuse, aggressive infiltrative malignant lymphoid cells with widespread angionecrosis, consistent with features of extranodal NK/T-cell lymphoma. To our knowledge, there is only one other reported case where the diagnosis of ENKTCL was made after patient presented with oro-nasal myiasis. Clinicians should have raised awareness on this atypical presentation so that further investigation and management can be implemented promptly.
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spelling ums.eprints-334252022-07-21T02:09:09Z https://eprints.ums.edu.my/id/eprint/33425/ A case report of Extranodal natural killer / T-cell lymphoma presenting as extensive myiasis Wong, Eugene Hung Chih Quah, Gabriel Xia Peng Yong, Doh Jeing RF341-437 Rhinology. Diseases of the nose, accessory sinuses, and nasopharynx We described a 56-year-old Indonesian man with one-month history of nasal obstruction and rapidly increasing nasal swelling and two weeks history of severe facial pain with foul smelling discharge, bleeding and noticing live maggots emerging from his nasal and oral cavity. On examination, he appeared cachexic with a markedly swollen, erythematous and deformed external nose. Live maggots, pus and necrotic tissues were found in both nasal cavities, with erosion of upper gingiva and hard palate. Patient was managed initially with tracheostomy under local anaesthesia, followed by removal of around 350 live maggots from the nasal cavities and debridement of necrotic tissues. A midline nasal cavity mass which extended laterally into the nasal cavity was found, along with a large defect over the gingival labial sulcus with necrotic hard palate and a communication between oral and nasal cavities. Biopsies were taken from the nasal mass, gingiva and hard palate. Histopathological results from the biopsies showed diffuse, aggressive infiltrative malignant lymphoid cells with widespread angionecrosis, consistent with features of extranodal NK/T-cell lymphoma. To our knowledge, there is only one other reported case where the diagnosis of ENKTCL was made after patient presented with oro-nasal myiasis. Clinicians should have raised awareness on this atypical presentation so that further investigation and management can be implemented promptly. Elsevier 2022 Article PeerReviewed text en https://eprints.ums.edu.my/id/eprint/33425/3/A%20case%20report%20of%20Extranodal%20natural%20killer.pdf text en https://eprints.ums.edu.my/id/eprint/33425/1/A%20case%20report%20of%20Extranodal%20natural%20killer%20_ABSTRACT.pdf Wong, Eugene Hung Chih and Quah, Gabriel Xia Peng and Yong, Doh Jeing (2022) A case report of Extranodal natural killer / T-cell lymphoma presenting as extensive myiasis. Annals of Medicine and Surgery, 75 (103419). pp. 1-3. ISSN 2049-0801 https://www.sciencedirect.com/science/article/pii/S2049080122001790 https://doi.org/10.1016/j.amsu.2022.103419 https://doi.org/10.1016/j.amsu.2022.103419
spellingShingle RF341-437 Rhinology. Diseases of the nose, accessory sinuses, and nasopharynx
Wong, Eugene Hung Chih
Quah, Gabriel Xia Peng
Yong, Doh Jeing
A case report of Extranodal natural killer / T-cell lymphoma presenting as extensive myiasis
title A case report of Extranodal natural killer / T-cell lymphoma presenting as extensive myiasis
title_full A case report of Extranodal natural killer / T-cell lymphoma presenting as extensive myiasis
title_fullStr A case report of Extranodal natural killer / T-cell lymphoma presenting as extensive myiasis
title_full_unstemmed A case report of Extranodal natural killer / T-cell lymphoma presenting as extensive myiasis
title_short A case report of Extranodal natural killer / T-cell lymphoma presenting as extensive myiasis
title_sort case report of extranodal natural killer t cell lymphoma presenting as extensive myiasis
topic RF341-437 Rhinology. Diseases of the nose, accessory sinuses, and nasopharynx
url https://eprints.ums.edu.my/id/eprint/33425/3/A%20case%20report%20of%20Extranodal%20natural%20killer.pdf
https://eprints.ums.edu.my/id/eprint/33425/1/A%20case%20report%20of%20Extranodal%20natural%20killer%20_ABSTRACT.pdf
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