title: Lymphoma of the nasal cavity and paranasal sinuses: A case series.
abstract: BACKGROUND
  Lymphomas of the sinonasal tract are a rare and heterogeneous subset of solid sinonasal neoplasms.
  
  
  OBJECTIVE
  To characterize, in this case series, presenting symptoms, treatment modalities, and outcomes for patients with sinonasal lymphoma within a single institution.
  
  
  METHODS
  Retrospective patient data were collected from an academic, oncologic center and entered into a repository designed to capture outcomes for sinonasal malignancies. Patient demographics, presenting symptoms, imaging findings, treatment modalities, and health status were retrospectively extrapolated and evaluated by using Kaplan-Meier estimations for survival probability.
  
  
  RESULTS
  Patients with sinonasal lymphoma with a mean follow-up of 50 months were identified (n = 18). Histologic diagnosis included the following: diffuse large B-cell lymphoma (n = 9), natural killer/T-cell lymphoma (n = 5), follicular lymphoma (n = 1), T-cell lymphoma (n = 1), and lymphoma-not otherwise specified (n = 2). The most frequent presenting symptoms were nasal obstruction (78%), facial pain (72%), facial swelling (50%), and nasal discharge (44%). Treatment before lymphoma diagnosis included antibiotics (83%), oral steroids (22%), decongestants (22%), and topical steroids (11%). Treatment regimens after diagnosis included both chemotherapy (94%) and chemoradiotherapy (56%). Survival rates by lymphoma subtype were 56% for B-cell lymphoma and 40% for natural killer/T-cell lymphoma. Overall, 2- and 5-year survival rates were 67% and 50%, respectively. The combination of chemotherapy and radiation resulted in significantly higher survival rates (p ≤ 0.001) than chemotherapy alone.
  
  
  CONCLUSIONS
  Sinonasal lymphomas are characterized by meager survival rates, which differ by histopathologic subtype. The diagnosis of sinonasal lymphoma is challenging because symptoms frequently parallel those of chronic rhinosinusitis. Increased awareness of these rare malignancies may improve detection and more timely treatment. Clinical trial registration NCT01332136.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California Davis, Sacramento, California, USA.
authors.forename: Toby O
authors.initials: TO
authors.lastname: Steele
authors.forename: Maria C
authors.initials: MC
authors.lastname: Buniel
authors.forename: Jess C
authors.initials: JC
authors.lastname: Mace
authors.forename: Edward
authors.initials: E
authors.lastname: El Rassi
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology*; D015508:Nasal Obstruction / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D009669:Nose Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D010256:Paranasal Sinuses / Q000473:pathology*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult