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Int J Clin Exp Pathol 2012;5(9):939-947

Original Article
Tumor cell nuclear diameter and CD30 expression as potential prognostic parameter in
patients with extranodal NK/T-cell lymphoma, nasal type

Junshik Hong, Sanghui Park2*, Hae Lim Baek, Joo Hyun Jung, Il Gyu Kang, Sun Jin Sym, Jinny Park,
Jeong Yeal Ahn, Eun Kyung Cho, Seon Tae Kim, Dong Bok Shin, Jae Hoon Lee*

1Department of Internal Medicine, Gachon University School of Medicine, Incheon, Korea; 2Department of Pathology,
Ewha Womans University School of Medicine, Seoul, Korea; 3Department of Otorhinolaryngology-Head and
Neck Surgery and 4Laboratory Medicine, Gachon University School of Medicine, Incheon, Korea. *Equal contributors.

Received August 6, 2012; Accepted October 1, 2012; Epub October 20, 2012; Published October 30, 2012

Abstract: Extranodal natural killer/T-cell lymphoma, nasal type (nasal ENKTL) is a distinct clinicopathologic entity of
lymphoid tumors with variable size and differentiation of tumor cells. Nasal ENKTL is related to infection of the tumor
cells with Epstein-Barr virus (EBV) and virtually all cases contain monoclonal episomal EBV DNA and detectable
EBV encoded small nuclear RNAs (EBERs). Several clinical factors are known for their relation to the prognosis, but
histopathologic prognostic factors of nasal ENKTL have not yet been well established. We evaluated the prognostic
value of the longest nuclear diameter of EBER+ tumor cells (NDTC) along with the result of CD30 expression. Twenty
two patients with newly diagnosed nasal ENKTL were evaluated regarding clinicopathologic characteristics. NDTC
was measured using a computerized image analysis system. The results were expressed as the mean diameter of ≥
50 cells in a patient. Median of the mean NDTC of the patients was 7.32 μm (5.15-11.27). Patients with larger mean
NDTC (≥ 7.35 μm) had a poorer event-free survival (EFS) than those with smaller mean NDTC (<7.35 μm; p = 0.024)
and had a tendency of inferior overall survival (OS) (p = 0.08). Patients with CD30 expression had a inferior EFS (p
= 0.018) and OS (p = 0.011) compared those without CD30 expression. The NDTC of EBV infected tumor cell and
CD30 expression had relation to survival in the current exploratory analysis. (IJCEP1208007).

Keywords: Extranodal NK/T-cell lymphoma, nasal type, epstein-barr virus, CD30, prognosis, nuclear diameter

Address all correspondence to:
Dr. Jae Hoon Lee
Department of Internal Medicine
Gachon University School of Medicine
21 Namdongdae-ro 774-gil,
Namdong-gu, Incheon, 405-760
Republic of Korea.
Tel: +82-32-460-2186; Fax: +82-32-460-3233
E-mail: jhlee@gilhospital.com;

Dr. Sanghui Park
Department of Pathology, Ewha Womans University
School of Medicine, 911-1 Mok-dong, Yangcheongu
Seoul, Korea, 158-710, Republic of Korea.
Tel: +82-2-2650-5731; Fax: +82-2-2650-2879