Huang Kuan-Jung, Wang Ling-Feng, Lee Ka-Wo, Ho Kuen-Yao, Kuo Wen-Rei, Tsai Kun-Bow, Chuang Jye-Hann
Department of Otolaryngology, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2003 Dec;19(12):639-43. doi: 10.1016/S1607-551X(09)70519-4.
Natural killer (NK)/T-cell lymphoma is the most common malignant lymphoma among sinonasal lymphomas. Diagnosis is difficult and prognosis is poor. Herein, we report the case of a 22-year-old male patient with sinonasal NK/T-cell lymphoma who first presented with nasal obstruction and left facial swelling. There was a mushroom-like mass over the hard palate, diffuse mucosal swelling in the left nasal cavity, and left orbital cellulitis. The patient underwent a Caldwell-Luc operation, functional endoscopic sinus surgery, and wide excision of the palate tumor. Pathologic examination of the maxillary sinus, nasal cavity, and palate tumor showed an NK/T-cell lymphoma. Two days after the operation, the patient suddenly had bloody stool and suffered hematemesis. A series of examinations revealed a small intestinal hemorrhage. Emergent exploratory laparotomy showed an ulcerative tumor mass with bleeding over the jejunum. Pathologic examination of the mass showed that it was the same as the sinonasal mass, an NK/T-cell lymphoma. We reviewed previous studies on nasal NK/T-cell lymphoma and found no report discussing patients with NK/T-cell lymphoma of both nasal and non-nasal origins. From this case, we learned that in patients with sinonasal NK/T-cell lymphoma, other sites may be involved.
自然杀伤（NK）/T细胞淋巴瘤是鼻窦淋巴瘤中最常见的恶性淋巴瘤。诊断困难且预后较差。在此，我们报告一例22岁男性鼻窦NK/T细胞淋巴瘤患者，其最初表现为鼻塞和左侧面部肿胀。硬腭上有一个蘑菇状肿物，左侧鼻腔黏膜弥漫性肿胀，伴有左侧眼眶蜂窝织炎。该患者接受了柯-陆氏手术、功能性鼻内镜鼻窦手术以及腭部肿瘤广泛切除术。对上颌窦、鼻腔和腭部肿瘤进行病理检查，结果显示为NK/T细胞淋巴瘤。术后两天，患者突然出现便血并呕血。一系列检查发现小肠出血。急诊剖腹探查显示空肠有一个溃疡性肿瘤肿物伴出血。肿物的病理检查结果显示与鼻窦肿物相同，为NK/T细胞淋巴瘤。我们回顾了以往关于鼻NK/T细胞淋巴瘤的研究，未发现有报告讨论同时存在鼻和非鼻来源NK/T细胞淋巴瘤的患者。从该病例中，我们了解到鼻窦NK/T细胞淋巴瘤患者可能累及其他部位。
