title: Sinonasal non-Hodgkin's lymphomas and Wegener's granulomatosis: a clinicopathological study.
abstract: Reports of sinonasal non-Hodgkin's lymphomas, analysed with monoclonal antibodies, are scarce, and differentiation of these lymphomas from Wegener's granulomatosis can be difficult. In this study, we investigated histopathologically and immunohistologically 20 cases of non-Hodgkin's lymphoma, primary in the sinonasal region, and sinonasal biopsies from 11 patients with Wegener's granulomatosis. All T-cell lymphomas (n = 7) and plasmacytomas (n = 4) were stage I at clinical presentation, while all B-cell lymphomas (n = 9) presented at higher stages. T-cell lymphomas tended to be more frequent in the nasal cavity and paranasal sinuses; B-cell lymphomas more often presented in the nasopharynx. Remarkably, 1 B-cell lymphoma expressed MT1, and 1 T-cell lymphoma expressed L26 (CD 20). The follow-up of 2 patients with a clinical diagnosis of Wegener's granulomatosis was suggestive of non-Hodgkin's lymphoma. Retrospective immunohistochemical analysis revealed that the original histological diagnosis of non-specific inflammation had to be changed to T-cell lymphoma, pleomorphic small cell type. We conclude that a biopsy from the sinonasal region with a dense inflammatory infiltrate, consisting predominantly of T-lymphocytes, renders a diagnosis of Wegener's granulomatosis unlikely and is at least suspicious of T-cell lymphoma. Immunohistochemical analysis is warranted for this type of biopsy.
authors.affiliation: Department of Pathology, Free University Hospital, Amsterdam, The Netherlands.
authors.forename: L A
authors.initials: LA
authors.lastname: Noorduyn
authors.forename: R
authors.initials: R
authors.lastname: Torenbeek
authors.forename: P
authors.initials: P
authors.lastname: van der Valk
authors.forename: P B
authors.initials: PB
authors.lastname: Drosten
authors.forename: G B
authors.initials: GB
authors.lastname: Snow
authors.forename: A J
authors.initials: AJ
authors.lastname: Balm
authors.forename: G J
authors.initials: GJ
authors.lastname: Ossenkoppele
authors.forename: C J
authors.initials: CJ
authors.lastname: Meyer
mesh_terms: D000328:Adult; D000912:Antibodies, Neoplasm / Q000032:analysis; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D014890:Granulomatosis with Polyangiitis / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008228:Lymphoma, Non-Hodgkin / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D008297:Male; D009669:Nose Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D010255:Paranasal Sinus Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D011241:Prednisone / Q000627:therapeutic use; D016019:Survival Analysis
chemical_list: D000912:Antibodies, Neoplasm; D003520:Cyclophosphamide; D011241:Prednisone