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A Diagnostic Dilemma of Sinonasal T Cell Lymphoma: Report of A Unique Case and Literature Review.
Gulf J Oncolog 2019; 1(31):83-89GJ

Abstract

BACKGROUND

Natural Killer/T-cell non-Hodgkin lymphomas are rare and aggressive disease of non-Hodgkin lymphoma characterized by angioinvasion, angiodestruction and necrosis. It has a strong association with Epstein-Barr virus (EBV) as the lymphoma cells are almost invariably infected with the clonal episomal form of EBV. Because of their rarity, it is a challenge to diagnose and treat them even to the experienced pathologists.

CASE PRESENTATION

The featured case describes a 40-year-old male who presented with symptoms suggestive for sinusitis. Further diagnostic investigation by the functional endoscopic sinus surgery (FESS) revealed a chronic sinusitis with multiple biopsies showing negative for malignancy, viral and bacterial infections and therefore undiagnosed for sinonasal NK/T-cell lymphoma. Subsequently after a month of surgery, he developed multiple lymph nodes in inguinal where biopsy revealed extranodal NK/T-cell non-Hodgkin lymphoma, high grade but in no time for treatment, he finally succumbed to the illness.

CONCLUSION

The case presented here was initially diagnosed as a chronic sinusitis, not as sinonasal NK/Tcell lymphoma which later developed into extranodal NK/T-cell lymphoma. The prognosis showed improvement for nasal lymphomas but remains poor for disseminated and extranasal lymphomas which are more aggressive with lower survival rate. It is clinically important to differentiate diseases for proper staging and monitoring as they require completely different treatment strategies.

Authors+Show Affiliations

Department of Otorhinolaryngology - Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia.Hospital Pulau Pinang, Georgetown, Pulau Pinang, Malaysia.Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia.Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia.Department of Otorhinolaryngology - Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31591996

Citation

V, Selvamalar, et al. "A Diagnostic Dilemma of Sinonasal T Cell Lymphoma: Report of a Unique Case and Literature Review." The Gulf Journal of Oncology, vol. 1, no. 31, 2019, pp. 83-89.
V S, Thamby SP, Al-Hatamleh MAI, et al. A Diagnostic Dilemma of Sinonasal T Cell Lymphoma: Report of A Unique Case and Literature Review. Gulf J Oncolog. 2019;1(31):83-89.
V, S., Thamby, S. P., Al-Hatamleh, M. A. I., Mohamud, R., & Abdullah, B. (2019). A Diagnostic Dilemma of Sinonasal T Cell Lymphoma: Report of A Unique Case and Literature Review. The Gulf Journal of Oncology, 1(31), pp. 83-89.
V S, et al. A Diagnostic Dilemma of Sinonasal T Cell Lymphoma: Report of a Unique Case and Literature Review. Gulf J Oncolog. 2019;1(31):83-89. PubMed PMID: 31591996.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Diagnostic Dilemma of Sinonasal T Cell Lymphoma: Report of A Unique Case and Literature Review. AU - V,Selvamalar, AU - Thamby,S P, AU - Al-Hatamleh,Mohammad Ahamed Issa, AU - Mohamud,Rohimah, AU - Abdullah,Baharudin, PY - 2019/07/01/accepted PY - 2019/10/9/entrez PY - 2019/10/9/pubmed PY - 2019/10/9/medline KW - Epstein Barr virus immunotherapy. KW - T cell KW - extranodal KW - lymphoma KW - nasal endoscopy KW - natural killer cells KW - sinonasal SP - 83 EP - 89 JF - The Gulf journal of oncology JO - Gulf J Oncolog VL - 1 IS - 31 N2 - BACKGROUND: Natural Killer/T-cell non-Hodgkin lymphomas are rare and aggressive disease of non-Hodgkin lymphoma characterized by angioinvasion, angiodestruction and necrosis. It has a strong association with Epstein-Barr virus (EBV) as the lymphoma cells are almost invariably infected with the clonal episomal form of EBV. Because of their rarity, it is a challenge to diagnose and treat them even to the experienced pathologists. CASE PRESENTATION: The featured case describes a 40-year-old male who presented with symptoms suggestive for sinusitis. Further diagnostic investigation by the functional endoscopic sinus surgery (FESS) revealed a chronic sinusitis with multiple biopsies showing negative for malignancy, viral and bacterial infections and therefore undiagnosed for sinonasal NK/T-cell lymphoma. Subsequently after a month of surgery, he developed multiple lymph nodes in inguinal where biopsy revealed extranodal NK/T-cell non-Hodgkin lymphoma, high grade but in no time for treatment, he finally succumbed to the illness. CONCLUSION: The case presented here was initially diagnosed as a chronic sinusitis, not as sinonasal NK/Tcell lymphoma which later developed into extranodal NK/T-cell lymphoma. The prognosis showed improvement for nasal lymphomas but remains poor for disseminated and extranasal lymphomas which are more aggressive with lower survival rate. It is clinically important to differentiate diseases for proper staging and monitoring as they require completely different treatment strategies. SN - 2078-2101 UR - https://www.unboundmedicine.com/medline/citation/31591996/A_Diagnostic_Dilemma_of_Sinonasal_T_Cell_Lymphoma:_Report_of_A_Unique_Case_and_Literature_Review DB - PRIME DP - Unbound Medicine ER -