Journal of Blood & Lymph

Primary Cutaneous Extranodal Natural Killer (NK)/T-cell Lymphoma, nasal type (PC-ENKTL), is a rare entity of malignancies of NK cells or cytotoxic T cells, characterized by an association with Epstein-Barr virus (EBV) infection. Despite its aggressive behavior, PC-ENKTL is mostly found as a localized disease. Data regarding PC-ENKTL with generalized skin lesions have only rarely been characterized in clinical studies so far. We present a case of PC-ENKTL, nasal type, in a 38-year–old female with a history of disseminated cutaneous plaques, ulcers and painful nodules that originated in her right leg skin as a small raised papule and expanded quickly over the entire body, ranging in diameter from 1 cm to 6 cm. The patient did not show any involvement of other sites except skin. Histologic, immunophenotypic, genetic and clinical features consistent with the diagnosis of primary cutaneous NK/T-cell lymphoma, nasal type. The status of immune cells was analyzed using a panel of monoclonal antibodies and revealed negative stain for CD163, CD68, programmed cell death (PD-1)/Programmed cell Death l Ligand 1(PD-L1), and FoxP3. Chemotherapy followed by radiotherapy was planned but the patient was experienced disease progression and died at 3 months as a result of lymphoma. In contrast to NK/T-cell lymphoma with localized disease, PC-ENKTL with generalized skin lesions tends to be more aggressive, with short survival and extremely poor response to therapy. We propose that the immune cell shift may be related to the severity of the patient.

Background: Malaria afflicts more than 90 countries in the tropical and subtropical region in which more than half of cases are present in Sub-Saharan Africa. Studying its prevalence is necessary to implement effective control measures. Therefore, this study was conducted to determine the three-year prevalence of malaria from peripheral blood smear examination.

Methods: A retrospective study was conducted from September 2016 to August 2019. All demographic details of subjects and positive malaria cases data were collected from laboratory registration book.

Results: The overall prevalence of smear positive malaria cases was 33·0%. Males (58·19%) were more prone to have a positive malaria smear than females (41·8%). A higher prevalence of malaria was observed in the adult age group (35%) compared with children under 5 years old children (27%). The highest prevalence of malaria cases was found in the year 2016 (48·8%) and 2017 (41%). High slide positive rate was seen in summer (40%) and autumn (39·52%). Months of July (45%) and September (40·6%) were noted to have the maximum number of cases. Plasmodium vivax constituted the most predominant malaria infections (78.06%), while P. falciparum was also present (21·26 %). Almost around 70% of cases were reported from patients living in and at the peripheries of Nakfa town.

Conclusion: Marked reduction trends were observed in morbidity related to malaria throughout the study years. However, vigilant surveillance is required especially during malaria transmission peaks from July to October which also overlap with harvesting seasons.