Nasal NK/T-cell lymphoma: A tragic case.

INTRODUCTION: Nasal NK/T-cell lymphoma is a rare clinicopathological entity, formerly called midline lethal granuloma. Following progress in histology and the routine use of immunohistochemistry, nasal NK/T-cell lymphoma was recognized as a distinct entity by WHO in 2001. CASE REPORT: The authors report the case of a 22-year-old, insulin-dependent diabetic woman, who presented with mid-facial inflammatory swelling following facial trauma, initially diagnosed and treated as cellulitis of the face. The subsequent course was rapidly progressive and fatal, with the development of midline destructive disease. Histological examinations concluded on NK/T-cell lymphoma. DISCUSSION: The various differential diagnoses of NK/T-cell lymphoma include gangrenous cellulitis, invasive mycotic rhinosinusitis, Wegener's granulomatosis, actinomycosis, and facial T-cell lymphoma. The clinical presentation of this case was atypical, resulting in delayed diagnosis and treatment. Treatment is based on radiotherapy and chemotherapy, but the prognosis remains very poor even when treatment is rapidly initiated.

[Hypertension and cardiovascular risk associated with obstructive sleep apnea in adult in Guadeloupe (French West Indies)]. / Hypertension artérielle et risque cardiovasculaire associés au syndrome d'apnées obstructives du sommeil chez l'adulte en Guadeloupe.

BACKGROUND AND PURPOSE: In Guadeloupe, data on the relationships between arterial hypertension and obstructive sleep apnea are unavailable. The aim of this study was: to assess the frequency of hypertension and non-dipper pattern evaluated by 48-hour ambulatory blood pressure monitoring in an adult population identified obstructive sleep apnea/non-obstructive sleep apnea during overnight polygraphy ; to determine the cardio-metabolic factors associated with obstructive sleep apnea. DESIGN AND METHOD: A cross-sectional study was realized at Pointe-à-Pitre Hospital. Patients were referred for suspected sleep apnea to sleep specialist and performed a nocturnal polygraphy. Diagnosis was confirmed if the apnea-hypopnea index was ≥ 5. We obtained two groups: sleep apnea/non-sleep apnea. All patients underwent 48-hour ambulatory blood pressure monitoring. The cardio-metabolic factors were identified and assessed (fasten level of hs-CRP and Homa-IR index). RESULTS: A total of 204 patients were included. Mean age at diagnosis was 54 ± 10 years, 63% were women. OSA was present in 69.6% with a higher frequency in men than in women. Difference was not significant between the two groups for hypertension frequency (84.5% vs 77%; P=0.22), non-dipper pattern (77.5% vs 76%; P=0.79) and hs-CRP. Differences for age, snoring, body max index, mean waist circumference, Homa-IR index, obesity, dyslipidemia, and type 2 diabetes were significant. CONCLUSIONS: Our data highlight raised frequency of cardiovascular metabolic factors in patients with obstructive sleep apnea and confirm their high cardiovascular risk.

[Vascular tumors of the nasal cavities: a retrospective study of 10 cases]. / Les tumeurs vasculaires des cavités nasales: etude rétrospective a propos de 10 cas.

UNLABELLED: Vascular tumors of the sinus cavities are rarely documented in the literature. They are characterized by a histological diversity. They can be benign or malignant. The most common histologic type is the hemangioma. Their management is not well codified, it benefited from advances in modern imaging and endoscopic surgery. The objective of the work is to study anatomical and clinical characteristics, therapeutic and outcome. PATIENTS AND METHODS: The observations of 10 vascular tumors of the nasal cavities collected between January 2009 and July 2011 were studied retrospectively. The management of these tumors was based on nasal endoscopy, imaging, biopsy, and some angiography for embolization. The epidemiological parameters, histopathological, clinical, therapeutic and outcome were studied. RESULTS: The average age was 25.4 years, male was marked with a sex ratio of 4. Epistaxis was the revealing sign. All tumors were benign, with a predominance of the hemangioma (4 cases), followed by angiofibroma of the septum (3 cases) and nasopharyngeal angiofibroma (3 cases). All patients were operated, by endonasal technique in 7 cas/10 and transfacial road in 3 cases. Embolization was performed in 5 patients, there were two hemangiomas and 3 nasopharyngeal fibromas. No case of recurrence has been noted so far. CONCLUSION: The vascular tumors of the nasal cavities are difficult to treat, especially when they reach a large volume and at an extension to adjacent areas, which makes the surgical procedure difficult and bloody. The use of selective embolization in these cases is required.