A case of cirrhosis concurrent with NK/T-Cell lymphoma and hemophagocytic lymphohistiocytosis: a clinical report and literature review

ObjectiveThis study aimed to investigate the clinical manifestations and therapeutic strategies for cirrhosis concurrent with NK/T-cell lymphoma and hemophagocytic lymphohistiocytosis (HLH), to enhance diagnostic and therapeutic insights into this rare disease with triple comorbidity.MethodsWe retrospectively analyzed the clinical data and diagnostic-therapeutic workflow of a patient admitted to our hospital in August 2024 with cirrhosis, NK/T-cell lymphoma, and HLH.ResultsThe patient was admitted to the Department of Infectious Diseases of our hospital with cirrhosis of unknown origin. Laboratory findings demonstrated trilineage cytopenia, coagulopathy, deranged blood biochemistry, markedly elevated ferritin, and hypercytokinemia. Serological testing confirmed Epstein-Barr virus (EBV) antibody positivity, while molecular assays detected high EBV DNA loads. Bone marrow cytomorphology and cervical lymph node histopathology corroborated NK/T-cell lymphoma with HLH. Whole-body PET/CT revealed multifocal lymph node involvement. Following multidisciplinary evaluation, the patient underwent hematology-directed management combining hepatoprotective therapy, antimicrobials, and chemotherapy (gemcitabine/oxaliplatin/mitoxantrone liposome), stabilizing disease.ConclusionThe co-occurrence of cirrhosis, NK/T-cell lymphoma, and HLH represents a rare clinical entity with a grim prognosis. This case highlights the necessity of early recognition and coordinated multidisciplinary interventions to optimize outcomes.