A Case of Primary Diffuse Large B Cell Lymphoma of the Maxillary Sinus Presenting as Epiphora

Primary sinusoidal non-Hodgkin’s lymphoma (NHL) is a very rare disease. The main symptoms of sinusoidal NHL are rhinorrhea, nasal obstruction, and post-nasal drip. Symptoms such as eye protrusion, diplopia, trismus, and periorbital pain can also occur. Epiphora is a very rare symptom of sinusoidal NHL, which can lead to a misdiagnosis of dacryocystitis or dacryostenosis. The authors report the case of a 46-year-old female patient who visited hospital for symptoms of epiphora, which did not improve even after 3 months of eye treatment, leading to a final diagnosis of maxillary NHL.

Solid Pseudopapillary Neoplasm of the Pancreas with Lymph Node Metastasis in a Young Male Patient / 대한소화기학회지

Solid pseudopapillary pancreatic neoplasms are rare. The male-to-female ratio is 1:9, and metastasis occurs only in a few cases. A 39-year-old male with a solid pseudopapillary neoplasm (SPN) with lymph node metastasis underwent ultrasonography, CT, and MRI, which revealed a mass (8 cm) in the pancreatic head. Fluorodeoxyglucose (FDG)-PET showed a hypermetabolic lymph node in the root area of the superior mesenteric artery (SMA). The patient underwent pylorus-preserving pancreaticoduodenectomy, which confirmed a peripancreatic lymph node metastasis. The lymph node of the SMA root area remained because of the encasing of the superior mesenteric artery. After 14 months of follow-up (with no adjuvant therapy initiated), the residual metastatic lymph nodes showed no change and no recurrence. In conclusion, surgery of the primary tumor for patients with SPN is recommended, even in cases with metastatic lymph nodes remaining.

Delayed Diagnosis Due to Septal Perforation in Patient with Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type / 대한이비인후과학회지

Extranodal natural killer (NK)/T-cell lymphoma, nasal type is a rare non-Hodgkin lymphoma originating in the nasal cavity or in the paranasal sinuses, and is etiologically closely related with the Epstein Barr Virus infection. It is more commonly found in East Asia, South America, and Mexico than in Europe or North America. Extranodal NK/T-cell lymphoma, nasal type typically shows a crust on the nasal mucosal surface, necrosis, and inflammation. Pathologically, it presents as significant vascular damage and destruction, with apparent tissue necrosis and cytotoxicity. These neoplasms are very aggressive and can show septal perforation, diffuse ulcer lesion on the nasal mucosa, fistula or epistaxis. We experienced a case of the extranodal NK/T-cell lymphoma, nasal type at the nasal septum, which was delayed in diagnosis due to septal perforation, which occurred after septoplasty in a 47-year-old female. Thus, we report this case with a review of literatures.

Nodular Fasciitis of the Parotid Gland, Masquerading as Pleomorphic Adenoma

It is difficult to distinguish nodular fasciitis (NF) from other neoplasm of the parotid gland, especially pleomorphic adenoma (PA) by fine needle aspiration cytology. A 39-year-old female noticed a mass in the parotid region. The aspirate material showed cohesive parts composed of the cells that had oval or spindle-shaped nuclei and relatively abundant cytoplasm and some cells with plasmacytoid features. The background substance was fibromyxoid. PA was diagnosed based on the cytologic findings. Subsequently, parotidectomy was performed and NF was diagnosed based on histologic and immunohistochemical findings. NF in the parotid region is rare and may be misdiagnosed as other benign or malignant tumors of the parotid gland. The clinical history of rapid growth and the presence of mitoses and inflammatory cells help to distinguish NF from PA. In addition, immunohistochemical stains for smooth muscle actin and CD68 are useful to confirm the diagnosis of NF.