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An Unusual Presentation Of Midline Lethal Granuloma

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An Unusual Presentation of Midline Lethal Granuloma.pdf (897.84 KB)

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2023

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SpringerLink

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Abstract

Extranodal natural killer T-cell lymphoma, nasal type (ENKTCL), is a rare form of non-Hodgkin lymphoma that is strongly related to Epstein-Barr Virus (EBV) infection and commonly presents as “midline lethal granuloma.” Herein, we report a middle-aged lady who presented with a two-week history of fever, sore throat and constitutional symptoms. Intraoral examination revealed a lacerated soft palate with an ulcerated uvula. A diagnosis of ENKTCL was confirmed through deep biopsies under general anaesthesia supplemented with a positive serum EBV genome. Unfortunately, she succumbed due to disease progression with left frontal brain metastasis with concurrent pulmonary tuberculosis before treatment was completed. The recommended treatment is multimodality with L-asparaginase-containing regimes chemotherapy in an advanced stage, relapsed, or refractory ENKTCL for better outcomes. The quantification of circulating plasma EBV deoxyribonucleic acid (DNA) is helpful as the baseline of tumour load and a biomarker for monitoring treatment response and prognostication. We advocate repeated and deeper core tissue biopsies.

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Granuloma, Lethal midline mass, Lymphoma, non Hodgkin, Extranodal NK-T-cell lymphoma, Epsteinbarr virus infections, Metastasis

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Ein Wan Chin, Jeyasakthy Saniasiaya, Shahrul Hitam, Hassan, E., & Ngan Kah Wai. (2023). An Unusual Presentation of Midline Lethal Granuloma. Indian Journal of Otolaryngology and Head & Neck Surgery. https://doi.org/10.1007/s12070-023-04466-x

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https://link.springer.com/article/10.1007/s12070-023-04466-x
 https://www.scopus.com/record/display.uri?eid=2-s2.0-85184888608&origin=resultslist&sort=plf-f&src=s&sid=a49b967dde61478abed853814bc9e606&sot=b&sdt=b&s=TITLE-ABS-KEY%28An+Unusual+Presentation+of+Midline+Lethal+Granuloma%29&sl=132&sessionSearchId=a49b967dde61478abed853814bc9e606&relpos=0
 https://oarep.usim.edu.my/handle/123456789/10783

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