Nasal-type NK/T-cell lymphoma with concurrent myocardial and central nervous system involvement: A rare case report

Rationale: Extranodal NK/T-cell lymphoma primarily occurs in the nasopharynx, oropharynx and upper gastrointestinal tract. Involvement of the myocardium and central nervous system (CNS) is rare and poses significant diagnostic challenges. However, due to its rarity, the clinical course and optimal management of such advanced cases remain poorly characterized. This case report aims to address this knowledge gap by presenting a patient with nasal NK/T-cell lymphoma who developed both myocardial and CNS involvement, highlighting the diagnostic pitfalls and the critical importance of early suspicion. Patient concerns: A 32-year-old male with nasal subtype NK/T-cell lymphoma who was clinically diagnosed with myocardial invasion through abnormal findings on 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography-computed tomography (PET-CT). During the later stages of chemotherapy, the patient confirmed CNS infiltration through laboratory diagnosis. Diagnoses: Nasal-type NK/T-cell lymphoma with concurrent myocardial and CNS involvement. Interventions: DDGP was selected as the first-line chemotherapy regimen, and famciclovir was administered for anti-EBV therapy. Outcomes: In the early phase of chemotherapy, the patient demonstrated significant clinical improvement. However, during the later course of chemotherapy, the patient was diagnosed with CNS involvement by lymphoma and succumbed shortly thereafter. Lessons: This case underscores that in patients with stage III or IV NK/T-cell lymphoma, lymphoma invasion should be the primary suspicion when cardiac or CNS abnormalities arise. Our case emphasizes the imperative for heightened clinical vigilance, prompt imaging and tailored treatment strategies are critical to potentially improve survival in such advanced cases.