View source for Extranodal NK-T-cell lymphoma diagnostic study of choice

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{{Extranodal NK-T-cell lymphoma}}
{{CMG}}; {{AE}} {{RG}}
== Overview ==


combination of these two findings on [[immunophenotyping]] of [[Frozen section procedure|frozen section]] specimen cells and [[Reverse transcription polymerase chain reaction|RT-PCR]] are confirmatory for [[Extranodal NK-T-cell lymphoma|Extranodal NK/T cell lymphoma]]:Detection of [[CD56]] and EBER1 on tumor cells and [[EBV]] [[DNA]] ([[RT-PCR]]).Pathological examination of [[frozen section]] specimen may misled the NK/T cell diagnosis.Circulating cell free EBV DNA levels by [[RT-PCR]] is a diagnostic factor for [[EBV]] associated [[malignancies]], Like [[Extranodal NK-T-cell lymphoma|extranodal NK/T cell lymphoma]]. Measuring both [[BamHI]] W DNA and LMP1 DNA is more useful as a prognosis predictor, these [[DNA|DNAs]] will decrease with treatment and increase with relapse. Recently, determination of negative immune checkpoints are considered as a drug target,in the case of [[Extranodal NK-T-cell lymphoma|extranodal NK/T cell lymphoma]], [[PD-L1]] will be expressed in the tumor, and patients with higher concentration of soluble [[PD-L1]] showed worse prognosis.

== Diagnostic Study of Choice ==

=== Study of choice ===

==== Investigations: ====

* Pathological examination of [[frozen section]] specimen may misled the NK/T cell diagnosis.<ref name="HarabuchiTakahara2019">{{cite journal|last1=Harabuchi|first1=Yasuaki|last2=Takahara|first2=Miki|last3=Kishibe|first3=Kan|last4=Nagato|first4=Toshihiro|last5=Kumai|first5=Takumi|title=Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type: Basic Science and Clinical Progress|journal=Frontiers in Pediatrics|volume=7|year=2019|issn=2296-2360|doi=10.3389/fped.2019.00141}}</ref>
* Circulating cell free [[EBV]] DNA levels by [[RT-PCR]] is a diagnostic factor for EBV associated malignancies, Like [[Extranodal NK-T-cell lymphoma|extranodal NK-T cell lymphoma.]]<ref name="LeiChan2000">{{cite journal|last1=Lei|first1=Kenny I. K.|last2=Chan|first2=Lisa Y.S.|last3=Chan|first3=Wing Y.|last4=Johnson|first4=Philip J.|last5=Lo|first5=Y. M. Dennis|title=Quantitative analysis of circulating cell-free Epstein-Barr virus (EBV) DNA levels in patients with EBV-associated lymphoid malignancies|journal=British Journal of Haematology|volume=111|issue=1|year=2000|pages=239–246|issn=0007-1048|doi=10.1046/j.1365-2141.2000.02344.x}}</ref><ref name="HarabuchiImai1996">{{cite journal|last1=Harabuchi|first1=Yasuaki|last2=Imai|first2=Shosuke|last3=Wakashima|first3=Junichi|last4=Hirao|first4=Motoyasu|last5=Kataura|first5=Akikatsu|last6=Osato|first6=Toyoro|last7=Kon|first7=Shinichiro|title=Nasal T-cell lymphoma causally associated with Epstein-Barr virus: Clinicopathologic, phenotypic, and genotypic studies|journal=Cancer|volume=77|issue=10|year=1996|pages=2137–2149|issn=0008-543X|doi=10.1002/(SICI)1097-0142(19960515)77:10<2137::AID-CNCR27>3.0.CO;2-V}}</ref>
* Measuring both [[BamHI]] W DNA and LMP1 DNA is more useful as a prognosis predictor, these DNAs will decrease with treatment and increase with relapse.<ref name="IshiiOgino2007">{{cite journal|last1=Ishii|first1=Hideyuki|last2=Ogino|first2=Takeshi|last3=Berger|first3=Christoph|last4=Köchli-Schmitz|first4=Nicole|last5=Nagato|first5=Toshihiro|last6=Takahara|first6=Miki|last7=Nadal|first7=David|last8=Harabuchi|first8=Yasuaki|title=Clinical usefulness of serum EBV DNA levels of BamHI W and LMP1 for Nasal NK/T-cell lymphoma|journal=Journal of Medical Virology|volume=79|issue=5|year=2007|pages=562–572|issn=01466615|doi=10.1002/jmv.20853}}</ref>
* Recently, determination of negative immune checkpoints are considered as a drug target,in the case of [[Extranodal NK-T-cell lymphoma|extranodal NK/T cell lymphoma]], [[PD-L1]] will be expressed in the tumor, and patients with higher concentration of soluble [[PD-L1]] showed worse prognosis.<ref name="NagatoOhkuri2017">{{cite journal|last1=Nagato|first1=Toshihiro|last2=Ohkuri|first2=Takayuki|last3=Ohara|first3=Kenzo|last4=Hirata|first4=Yui|last5=Kishibe|first5=Kan|last6=Komabayashi|first6=Yuki|last7=Ueda|first7=Seigo|last8=Takahara|first8=Miki|last9=Kumai|first9=Takumi|last10=Ishibashi|first10=Kei|last11=Kosaka|first11=Akemi|last12=Aoki|first12=Naoko|last13=Oikawa|first13=Kensuke|last14=Uno|first14=Yuji|last15=Akiyama|first15=Naoko|last16=Sado|first16=Masatoshi|last17=Takei|first17=Hidehiro|last18=Celis|first18=Esteban|last19=Harabuchi|first19=Yasuaki|last20=Kobayashi|first20=Hiroya|title=Programmed death-ligand 1 and its soluble form are highly expressed in nasal natural killer/T-cell lymphoma: a potential rationale for immunotherapy|journal=Cancer Immunology, Immunotherapy|volume=66|issue=7|year=2017|pages=877–890|issn=0340-7004|doi=10.1007/s00262-017-1987-x}}</ref><ref name="TaubeKlein2014">{{cite journal|last1=Taube|first1=J. M.|last2=Klein|first2=A.|last3=Brahmer|first3=J. R.|last4=Xu|first4=H.|last5=Pan|first5=X.|last6=Kim|first6=J. H.|last7=Chen|first7=L.|last8=Pardoll|first8=D. M.|last9=Topalian|first9=S. L.|last10=Anders|first10=R. A.|title=Association of PD-1, PD-1 Ligands, and Other Features of the Tumor Immune Microenvironment with Response to Anti-PD-1 Therapy|journal=Clinical Cancer Research|volume=20|issue=19|year=2014|pages=5064–5074|issn=1078-0432|doi=10.1158/1078-0432.CCR-13-3271}}</ref>

==== Diagnostic results ====
*The accompaniment of following findings on performing immunophenotyping on frozen section specimen and RT-PCR are confirmatory for Extranodal NK/T cell lymphoma:
**Detection of CD56 and EBER1 on tumor cells<ref name="HarabuchiTakahara2009">{{cite journal|last1=Harabuchi|first1=Yasuaki|last2=Takahara|first2=Miki|last3=Kishibe|first3=Kan|last4=Moriai|first4=Shigetaka|last5=Nagato|first5=Toshihiro|last6=Ishii|first6=Hideyuki|title=Nasal natural killer (NK)/T-cell lymphoma: clinical, histological, virological, and genetic features|journal=International Journal of Clinical Oncology|volume=14|issue=3|year=2009|pages=181–190|issn=1341-9625|doi=10.1007/s10147-009-0882-7}}</ref>
**EBV DNA (RT-PCR)<ref name="HarabuchiImai1996" />

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==References==
{{Reflist|2}}
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