RESUMO
Paranasal sinus lymphoma (PNL) is a rare presentation of extranodal non-Hodgkin lymphoma (NHL) with a natural history different from other types of lymphoma. The maxillary sinus is the most common paranasal sinus involved in NHL. Involvement of the central nervous system (CNS) is a rare complication of PNL. In this case report, we present a case of diffuse large B cell lymphoma (DLBL) that developed in the left maxillary sinus and relapsed as a left frontal brain mass after four years of disease remission.
RESUMO
OBJECTIVES/HYPOTHESIS: Extranodal natural killer/T-cell Lymphoma (ENKTL) is a rare, aggressive malignancy that preferentially affects the paranasal region. This study analyzes the demographic, clinicopathologic, incidence, and survival characteristics of sinonasal ENKTL (SN-ENKTL) and extranasal ENKTL (EN-ENKTL) in a comparative fashion. STUDY DESIGN: Retrospective analysis. METHODS: The Surveillance, Epidemiology, and End Results database was queried; 528 cases were available for frequency and incidence analysis, and 473 for survival analysis. Data were examined according to age, gender, race, histology, the presence of systemic (or B) symptoms, treatment, and Ann Arbor stage. RESULTS: Extranasal disease was a poor prognostic factor (hazard ratio [HR] = 1.69, 95% confidence interval [CI] = 1.30-2.19, P < .05). Patients with EN-ENKTL were older (mean 53.8 vs. 49.9 years, P < .05), most were male (72.5% vs. 59.8%, P < .05), and they were more likely to present with stage IIIE/IV disease (38.33% vs. 18.26%, P < .05). B symptoms were present in 38.41% of the EN-ENKTL group (vs. 22.86%, P < .05), and were a poor prognostic factor in this group only (HR = 1.6593, 95% CI = 1.05-2.62, P < .05). Radiation therapy demonstrated a survival advantage among both groups, especially in early stage disease. CONCLUSIONS: SN-ENKTL carries a significantly better prognosis than EN-ENKTL, which presents at more advanced stages. Radiation therapy was associated with increased survival in both groups, especially in cases of localized disease. LEVEL OF EVIDENCE: 2b.
Assuntos
Linfoma Extranodal de Células T-NK/epidemiologia , Neoplasias Nasais/epidemiologia , Neoplasias dos Seios Paranasais/epidemiologia , Programa de SEER , Feminino , Seguimentos , Humanos , Incidência , Linfoma Extranodal de Células T-NK/diagnóstico , Masculino , Pessoa de Meia-Idade , Células T Matadoras Naturais/patologia , Estadiamento de Neoplasias , Neoplasias Nasais/diagnóstico , Neoplasias dos Seios Paranasais/diagnóstico , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Estados Unidos/epidemiologiaRESUMO
Malignant lymphoma of the sinus is very rare but potentially radiocurable neoplasm. The disease is tend to be localized to the sinus and spread to adjacent local structure on initial presentation, and change to generalized lymphoma is uncommon. Most of sinus lymphoma is diffuse histiocytic type. Radiotherapy to the primary and neck nodes is the treatment of choice, and a survival rate of 50~70% can be expected.