Published online Apr 26, 2019. doi: 10.12998/wjcc.v7.i8.992
Peer-review started: December 19, 2018
First decision: January 19, 2019
Revised: February 21, 2019
Accepted: March 26, 2019
Article in press: March 26, 2019
Published online: April 26, 2019
Extranodal natural killer (NK) T-cell lymphoma (ENKTL), nasal type is a rare subtype of extranodal non-Hodgkin lymphoma characterized by vascular damage and necrosis. The lesions usually present in the nasal cavity and adjacent tissues, however, the disease originates from the gastrointestinal or genitourinary tract in 25% of cases. Since rectal involvement in ENKTL is rare, rectal symptoms in the course of ENKTL are often misdiagnosed and considered to be related to benign diseases such as rectal fistula or perianal abscess.
We report the case of a 24-year-old Han Chinese female who initially presented with a perianal abscess that was subsequently diagnosed as nasal type ENKTL. Due to typical perianal pain, perianal abscess was diagnosed and surgical incision and drainage were performed. After recurrent, severe anal hemorrhages leading to hypovolemic shock and multiple surgeries, a diagnosis of ENKTL was made. The patient’s condition gradually deteriorated, and she died shortly after initiation of chemotherapy.
Systemic and neoplastic diseases should be included in the differential diagnosis of any potentially benign perianal abscess complicated with recurrent hemorrhages.
Core tip: The case highlights the need to include systemic and neoplastic diseases in the differential diagnosis of any potentially benign perianal abscess complicated with recurrent hemorrhages. A 24-year-old Han Chinese female, initially diagnosed with perianal abscess, underwent the surgical incision and drainage. The symptoms and the results of imaging, laboratory analysis, and colonoscopic biopsy were non-specific. After recurrent, severe anal hemorrhages leading to hypovolemic shock and multiple surgeries, a final diagnosis of extranodal natural killer/T cell lymphoma was made based on the result of histopathological examination. The patient’s condition gradually deteriorated, and she died shortly after initiation of chemotherapy.