Sinonasal lymphoma: case series and review of the literature.
BACKGROUND
Sinonasal lymphoma is a rare rhinologic entity. We present a case series and review the literature surrounding the diagnosis and management of this disease.


METHODS
A pathology database spanning 22 years at a tertiary care center was searched for a diagnosis of lymphoma in the paranasal sinuses or the nasal cavity. Seventeen cases were identified, and retrospective chart review was performed.


RESULTS
Maxillary and ethmoid sinuses were affected more frequently (n = 8 patients each) than sphenoid and frontal sinuses (n = 5 patients each). Histologically, the most common type was diffuse large B-cell lymphoma (53%, 9 patients), followed by extranodal natural killer/T-cell lymphoma (ENKL, 21%, 3 patients). Presenting symptoms included nasal obstruction and rhinorrhea (53%, 9 patients) and diplopia (18%, 3 patients); and radiographic imaging demonstrated a discrete mass (59%, 10 patients), sinus opacification (53%, 9 patients), and/or bony erosion (35%, 6 patients). Treatment included chemotherapy alone (71%, 12 patients), chemotherapy and radiation (6%, 1 patient), and radiation alone (6%, 1 patient). The 2-year and 5-year overall survival rates were 75% and 53%, respectively, whereas disease-free 2-year and 5-year survival rates were 70% and 49%, respectively.


CONCLUSIONS
Lymphoma of the nasal cavity and paranasal sinuses is extremely rare, may mimic benign processes, and may manifest either in an isolated fashion or in conjunction with systemic disease. B-cell lymphomas, a more favorable diagnosis, account for a majority of cases, whereas ENKL is associated with rapid disease progression and death. Chemotherapy and radiation are the main therapies. Histologic diagnosis is of paramount importance, and clinicians must remain cognizant of this entity to differentiate it from other sinonasal malignancies.
Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA.
Kevin A
KA
Peng
Ashley E
AE
Kita
Jeffrey D
JD
Suh
Sunita M
SM
Bhuta
Marilene B
MB
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001402:B-Lymphocytes / Q000473:pathology; D059248:Chemoradiotherapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D016393:Lymphoma, B-Cell / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D010255:Paranasal Sinus Neoplasms / Q000453:epidemiology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013601:T-Lymphocytes / Q000473:pathology; D016896:Treatment Outcome
chronic rhinosinusitis; endoscopic sinus surgery; paranasal sinus diseases; radiology