Sinonasal lymphoma refers to the involvement of the nasal cavity andor paranasal sinuses with lymphoma. Primary lymphoma of nasal cavity and paranasal sinuses. In this study, we describe a failure pattern, b outcome, c influence of previously reported prognostic variables on the outcome in cats with suspected localized sinonasal lymphoma. Twentythree were male and 10 were female, with an age range of 7 to 91 years mean, 63 years. Gene mutation analysis of sinonasal lymphomas in indonesia. Trigeminal neuropathy is characterized by sensory disturbance of the division of trigeminal nerve, and sometimes is associated with pain. Nonhodgkins lymphoma of nasal cavity and paranasal sinuses. Primary nonhodgkin lymphoma of the sinonasal cavities. At the time of presentation, the disease had involved the orbit and extended into the.
Cases of extensive nasal polyps rarely occur and may mimic more aggressive lesions of the nose and paranasal sinuses. Clinicopathological analysis of sinonasal malignant. Mucosaassociated lymphoid tissue malt is a specialized form of lymphoid tissue that may be acquired at sites in response to chronic inflammation. Likewise, sinonasal lymphoma is infrequently demonstrated initially with cranial neuropathy. Analysis of survival in 852 cases, american journal of otolaryngology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. A majority 68% had advanced tumor at diagnosis stage iv on the ann arbor classi. The clinical symptom spectrum includes nasal obstruction, rhinorrhea, bloody dischargeepistaxis, postnasal drip, facial swelling, neck mass, orbital symptoms, fever, and body weight loss. Extranodal nkt cell lymphoma, nasal type enktclnt also termed angiocentric lymphoma, nasaltype nk lymphoma, nktcell lymphoma, polymorphicmalignant midline reticulosis, and lethal midline granuloma is a rare type of lymphoma that commonly involves midline areas of the nasal cavity, oral cavity, andor pharynx at these sites, the disease often takes the form of massive, necrotic, and. May 01, 2006 the incidence of sinonasal lymphomas is higher in asian countries than in the west. Nov 26, 2011 the presenting symptoms of sinonasal lymphoma are usually similar to those of benign inflammatory diseases. Lymphoma is neoplastic disease of nodal and extranodal lymphoid tissue, with spectrum ranging from low to high grade aggressive malignant pattern. The records of 37 patients with lymphoma of the nose and paranasal sinuses in an 18year period were studied.
Sinonasal malignancies, a highly heterogeneous group of cancers, account for less than 1% of all cancers and less than 3% of all upper aerodigestive tract tumors. Virusassociated neoplasms of the nasopharynx and sinonasal. Sinonasal lymphoma, a rare form of nonhodgkins lymphoma nhl involving the nasal cavity andor paranasal. Lymphoid neoplasms of the sinonasal tract and their. They have a variable presentation from fulminant destructive manifestations to chronic indolent type of disease and may mimic as carcinomas and. Sinonasal anaplastic lymphoma kinase alkpositive anaplastic large cell lymphoma alcl without nodal involvement is extremely rare and the rarity of this tumor often leads to diagnostic dilemma. Infectious mononucleosis affecting sinonasal mucosa blood. Here is one such case report of sinonasal t cell lymphoma where there was a difficulty in diagnosis and required. However, lymphomas must be included in the differential diagnosis of unilateral lesions of the nasal cavity and paranasal sinuses. In 24 patients with stage i and ii nonhodgkin lymphomas of the sinonasal cavities, the ct appearances and clinical data were. May 20, 2006 aim of this study was to investigate the clinical characteristics, management and prognosis of nonhodgkin lymphomas of the nasal cavity and paranasal sinuses.
Reports of sinonasal nonhodgkins lymphomas, analysed with monoclonal antibodies, are scarce, and differentiation of these lymphomas from wegeners granulomatosis can be difficult. Only 2 of 11 cases tested one in an hivpositive patient and one of lymphomatoid granulomatosis type were epsteinbarr virus ebvpositive. A case report of aggressive chronic rhinosinusitis with. Primary sinonasal malignancies constitute only 3% of head and neck malignancies and only 0. Thirtytwo patients diagnosed as having sinonasal lymphoma from. Lymphoma of the nasal cavity and paranasal sinuses. Dec 30, 2015 researchers in new zealand recently detailed a unique case study of a bcell all acute lymphoblastic leukemia patient with late relapse to the nasal septum as a sinonasal lymphoblastic lymphoma, and with genetic support for the septum as a newly described sanctuary site. Sinonasal nonhodgkins lymphoma in patients infected with. Sinonasal lymphomas are usually of nhl type and prognosis is worse than lymphomas of other locations. A case of extensive nasal polyposis with unusually aggressive behavior and its management is presented. Prognostic indicators of survival in sinonasal extranodal.
The separation and classification of epithelial or neuroepithelial tumours is sometimes challenging, especially when treatment and prognosis are different. Oct 31, 2005 sinonasal lymphoma sl is a rare form of extranodal lymphoma. Unlimited viewing of the articlechapter pdf and any associated supplements and figures. Nonhodgkins lymphoma nhl is a frequent complication of human immunodeficiency virus hiv infection, but involvement of the sinonasal region has only rarely been reported. Lymphomas of the sinonasal tract are a rare and heterogeneous subset of solid sinonasal neoplasms. Early diagnosis and staging are necessary for effective treatment. Nasal lymphoma is the most common nasal tumor in cats, exceeding other neoplasms and inflammatory diseases in recent studies. Sinonasal lymphoma is a nonhodgkin lymphoma nhl representing 1. Surgery in the multimodality treatment of sinonasal malignancies. Sinonasal lymphomas are aggressive locally destructive midfacial necrotizing lesions.
Nonhodgkins lymphoma of the sino nasal tract in children abstract childhood head and neck cancers are relatively uncommon. Tnk cell nonhodgkins lymphoma of the sinonasal tract. Diffuse large bcell lymphoma of the sinonasal tract. Extranodal nktcell lymphoma, nasal type enktcl sinonasal tract, especially nasal cavity, is the typical site of origin for extranodal nktcell lymphoma, nasal type, although the lymphoma can arise from other extranodal sites. Poor prognosis warrants early treatment although diagnosis is challenging and frequently delayed. Presenting symptoms of sinonasal lymphoma are variable but are usually similar to those of benign inflammatory diseases. A 27yearold male patient visited the emergency department of a tertiary center, complaining of recurrent episodes of epistaxis. Sinonasal nktcell lymphoma with upper gastrointestinal bleeding. Sinonasal disease is one of the most common clinical head and neck pathologies. Sinonasal mucosaassociated lymphoid tissue lymphoma. The majority of sinonasal pathology is inflammatory with neoplasms comprising approximately 3% of all head and neck. Malignant neoplasms of the sinonasal tract encompass a wide variety of epithelial, lymphoid and mesenchymal tumours. The united states national cancer institutes surveillance, epidemiology, and end results seer registry was utilized to extract data regarding sinonasal diffuse large bcell lymphoma between 1973 and 2009. Most of them initially diagnosed as lethal midline granulomas, a term which is slowly replaced by sinonasal lymphoma.
Clinical presentation presenting symptoms of sinonasal lymphoma are variable but are usually similar to tho. To determine retrospectively the primary site of origin of sinonasal lymphomas with computed tomography ct and correlate the ct findings with histologic phenotype and clinical outcome. Herein, we report the case of a 22yearold male patient with sinonasal nktcell lymphoma who first presented with nasal obstruction and. Primary nonhodgkins malignant lymphoma of the sinonasal tract.
K nakamura, s uehara, j omagari, n kunitake, m kimura, y makino, j murakami, k jingu, k masuda. Case report sinonasal lymphoma presenting as a probable. Primary nonhodgkins malignant lymphoma of the sinonasal. The role of a monoclonal antibody 11c8b1 as a diagnostic. In western populations, nonhodgkin lymphoma nhl of the sinonasal tract nasal cavity and paranasal sinuses are uncommon neoplasma, representing 0. Sakagaminonhodgkins malignant lymphoma of the sinonasal tracttreatment outcome for 53 patients according to real classification. The age distribution for these two subtypes is very distinct and the b symptoms were more. Sinonasal relapses of an isolated primary nktcell lymphoma of the testis are very rare. Researchers in new zealand recently detailed a unique case study of a bcell all acute lymphoblastic leukemia patient with late relapse to the nasal septum as a sinonasal lymphoblastic lymphoma, and with genetic support for the septum as a newly described sanctuary site. It is divided into nasal and extranasal subgroups depending on the primary site.
Bcell nonhodgkins lymphoma of the paranasal sinuses. Extranodal nonhodgkin lymphoma of the sinonasal cavities. Author links open overlay panel chihiro hatta a hiroshi ogasawara a jun okita a. Sinonasal lymphoma rads iowa head and neck protocols. Pdf diffuse large bcell lymphoma of the sinonasal tract. Sinonasal nktcell lymphoma with upper gastrointestinal. Primary isolated nktcell lymphoma of the testis is rare. Nonhodgkins lymphomas nhls of the sinonasal tract are uncommon neoplasms that can be morphologically. In the present study, there was no significant difference between presenting symptoms in tumor and inflammatory lesions. Ojhas vol 8 issue 29 bist ss, varshney s, singh rk, bhagat s, gupta n. We report an unusual presentation of sinonasal lymphoma in which the patient presented with no nasal symptomsonly a loss of vision in one eye and lateral rectus muscle palsy.
Sinonasal lymphomas comprise nktcell nktcl type and bcell type with unique geographical development. Mar 01, 2014 read diffuse large bcell lymphoma of the sinonasal tract. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Morphologically and radiographically, sinonasal lymphomas are difficult to distinguish from other malignant neoplasms or non neoplastic processes. Hodgkin lymphoma nhl in western countries, but lymphoma of the primary paranasal sinuses ppsl is rare and represents only 017% of all lymphomas in the kiel lymph node registry. This study describes the radiologic features of nine cases of proven nasal t cellnatural killer cell lymphoma. The purpose of this study was to analyze computed tomography ct and magnetic resonance mr images and to evaluate the maximum standardized uptake value suv max of positron emission tomography petct parameters between sinonasal nonhodgkins lymphoma nhl and squamous cell carcinoma scc, knowing the imaging features that distinguish. Differential diagnosis of sinonasal lymphoma and squamous. Therefore, the diagnosis of sinonasal lymphoma is a challenge for rhinologists.
Most lowgrade, bcell, nonhodgkin lymphomas that occur at extranodal sites derive from acquired malt. Nasal t cellnatural killer cell lymphoma is often a locally destructive t stages 3 and 4 disease, typically presenting with obliteration of the nasal passages and maxillary sinuses. Combined modality management of sinonasal anaplastic. Here is one such case report of sinonasal t cell lymphoma where there was a difficulty in diagnosis and required an incisional biopsy. Sep 11, 2018 importantly, 11 sinonasal undifferentiated carcinomas n 14, 79% and 3 100% highgrade neuroendocrine carcinomas, large cell type were 11c8b1 immunopositive. Nov 28, 2019 elham vali betts, regina gandouredwards. Lymphomas of the sinonasal tract are uncommon lymphomas that account for only 15% of all non. The difference in clinical features and treatment outcomes between localized sinonasal diffuse large b cell lymphoma sndlbcl and sinonasal extranodal nkt cell lymphoma snenktl is unclear.
Diffuse large bcell lymphomas dlbcls are among the most common of sinonasal lymphomas. Of all head and neck cancers occurring in children, nonhodgkins lymphoma nhl is the most common, others being rhabdomyosarcoma and nasopharyngeal carcinoma. A clinicopathologic and immunophenotypic study of 120 cases. It is usually primary in origin and to our knowledge the sinonasal region has never been. Sinonasal inverted papillomas harbor hpv in about 25% of cases. Combined modality management of sinonasal anaplastic lymphoma.
Involvement of the adjacent alveolar bone, hard palate, orbits, and nasopharynx is found in more than 50% of cases and is associated with extensive softtissue. Sinonasal relapses of a primary isolated extranodal nktcell. Sinonasal lymphoma presenting as a probable sanctuary site. Biopsies are usually small and limited, resulting in considerable. Background sinonasal lymphoma presents as an unremitting ulceration a ecting midline sinonasal region and surrounding structures. Nonhodgkins malignant lymphoma of the sinonasal tract treatment outcome for 53 patients according to real classification. Epidemiology and clinical features nonhodgkin s lymphoma of the sinonasal tract is rare in. Therefore, we analyzed a total of 47 patients with localized sndlbcl and 211 patients with localized snenktl. With the combined chemotherapy and local radiation, patients with lymphoma of the nasal cavity and paranasal sinuses have a better prognosis. Aprjun 2009 primary nonhodgkins malignant lymphoma of the sinonasal tract. Comparison of these two types of lymphoma showed that lymphomas involving. The age distribution for these two subtypes is very distinct and the b symptoms. Sinonasal lymphoma sl is a rare form of extranodal lymphoma. Enktcl is a very aggressive entity, even at an early stage, therefore, requiring a multimodal treatment approach including chemotherapy and radiotherapy.
Sinonasal relapses of a primary isolated extranodal nkt. Thirtytwo patients diagnosed as having sinonasal lymphoma. The need for optimal mapping of sinonasal neoplasms has led to the ascendancy of mri in this setting. The sinonasal nhl was diagnosed as natural killertcell lymphoma n 28 and diffuse large bcell lymphoma n 11. Infectious mononucleosis affecting sinonasal mucosa, blood, volume 4, issue 22, 28 november 2019, pages 1996, s. Thirty 91% involved paranasal sinuses, 10 with nasal involvement, whereas three cases had nasal, but not. Different clinical characteristics and treatment strategies. Nonhodgkins malignant lymphoma of the sinonasal tract. Comparison of these two types of lymphoma showed that lymphomas involving sinuses without nasal involvement were predominantly dlbcls 20 of 21, whereas nasal cavity lymphomas without sinus involvement were usually nktcell. This study expands upon epidemiologic, prognostic, and treatment factors for os and disease. Seven patients had risk factors for lymphoma infection by hiv, ebv or chronic lymphocytic leukemia. Magnetic resonance imaging versus computed tomography and. To characterize, in this case series, presenting symptoms, treatment modalities, and outcomes for patients with sinonas ymphoma with n a single institution.
Herein, we report the case of a 22yearold male patient with sinonasal nktcell lymphoma who first presented with nasal obstruction and left facial swelling. It presents as an unremitting ulceration with progressive destruction of midline sinonasal and surrounding structures. Natural killer nktcell lymphoma is the most common malignant lymphoma among sinonasal lymphomas. It has been predominantly reported in pediatric, adolescent and young adult patients, mostly of asian origin. Who first recognised extranodal nktcell lymphoma enktcl in 2001, thanks to technical advances in anatomopathology and immunohistochemistry. Nasal t cellnatural killer cell lymphoma is a new clinicopathologic entity with a characteristic immunophenotypic profile and distinct clinical features. Bcell nonhodgkins lymphoma of the paranasal sinuses volume 108 issue 3 solaiman juman, philip robinson, avinash balkissoon, kara kelly skip to main content we use cookies to distinguish you from other users and to provide you with a better experience on our websites. Primary nonhodgkins lymphomas nhl of the sinonasal tract are rather uncommon entities. A total of 852 cases of sinonasal dlbcls were found. Trigeminal neuropathy secondary to perineural invasion of sinonasal lymphoma is extremely rare. Small round blue cell tumors of the sinonasal tract. Overall 12 patients with nonhodgkin malignant lymphoma, at our institute, were studied over. In 16 cases dlbcls, 1 burkittlike lymphoma, 1 nasal nktcell lymphoma, and 1 lymphoma of uncertain lineage, the orbit was invaded by lymphoma.
Its incidence has been reported to be higher in asian and south american countries. The presenting symptoms of sinonasal lymphoma are usually similar to those of benign inflammatory diseases. Hodgkins lymphoma of the sinonasal tract request pdf. In our series, the most common lymphoma to arise in the sinonasal area is dlbcl, followed by nasal nktcell lymphoma. In this study, we investigated histopathologically and immunohistologically 20 cases of nonhodgkins lymphoma, primary in the sinonasal region, and sinonasal biopsies from 11 patients with wegeners granulomatosis. One of the most challenging diagnostic categories within tumors of the sinonasal tract is the small round blue cell tumors. Lymphomas have been categorized as hodgkin lymphoma hl and nonhodgkin lymphoma nhl. Squamous cell carcinoma, keratinizing or nonkeratinizing and, usually, the poorly differentiated type need to be. These lesions may originate from any of the histopathologic components of the sinonasal cavities, including schneiderianmucosa,minorsalivaryglands,neuraltissue,andlymphatics. Outcome and failure patterns of localized sinonasal. Developed by renowned radiologists in each specialty, statdx provides comprehensive decision support you can rely on sinonasal nonhodgkin lymphoma.
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