Ou Chang-Hsien, Chen Clayton Chi-Chang, Ling Jin-Ching, Chai Jyh-Wen, Wu Chen-Hao, Chen Wen-Hsien, Hung Hao-Chun, Ho Tzu-Lung
Department of Radiology, Buddhist Tzu-Chi General Hospital, Taichung Branch, and Department of Radiological Technology, Central Taiwan University of Science and Technology, Taichung, Taiwan, ROC.
J Chin Med Assoc. 2007 May;70(5):207-12. doi: 10.1016/S1726-4901(09)70359-4.
Primary nasal natural killer (NK)/T-cell lymphoma is the most common cellular subtype seen in nasal lymphomas. It is rare in the Western population but occurs more frequently in Asia, South America, and Mexico. The purpose of this study was to describe the computed tomography (CT) and magnetic resonance (MR) imaging findings of primary nasal NK/T-cell lymphoma.
During the period between January 1990 and June 2006, the CT (n=24) and MR (n=6) images of 24 patients with biopsy-proved nasal NK/T-cell lymphoma were reviewed retrospectively. Both CT and MR images were evaluated for site and extent of disease and for pattern of involvement of adjacent areas.
The most common symptoms at presentation were nasal obstruction, nasal discharge, and epistaxis. There was involvement of the unilateral nasal cavity in 16, bilateral nasal cavity including nasal septum in 5 and nasal choana in 3. Sites of extension outside the nasal cavity included tumor extension into paranasal sinuses (n=15), nasopharynx (n=5), nasal labial fold (n=3), oropharynx (n=2), infratemporal fossa (n=2), other subcutaneous soft tissue of the face (n=2) and anterior cranial fossa base (n=1). Bony destruction was demonstrated in 18 cases, involving the sinus bony wall (n=15), nasal turbinate (n=10), lamina papyracea (n=6), orbital floor (n=3), and hard palate (n=2). Regional lymphadenopathy was also detected in 3 patients with nasal NK/T-cell lymphoma.
The CT and MR appearances of nasal NK/T-cell lymphoma are nonspecific, and the diagnosis requires histologic confirmation. However, the differential diagnosis of nasal NK/T-cell lymphoma should be included if the images present soft tissue of the nasal cavity with bony erosion or destruction; involvement of the orbital cavity, nasopharynx and infratemporal fossa; and subcutaneous or nasolabial fold soft tissue infiltration, especially in Asian populations.
原发性鼻自然杀伤（NK）/T细胞淋巴瘤是鼻淋巴瘤中最常见的细胞亚型。在西方人群中罕见，但在亚洲、南美洲和墨西哥更为常见。本研究的目的是描述原发性鼻NK/T细胞淋巴瘤的计算机断层扫描（CT）和磁共振（MR）成像表现。
回顾性分析1990年1月至2006年6月期间24例经活检证实的鼻NK/T细胞淋巴瘤患者的CT（n=24）和MR（n=6）图像。对CT和MR图像进行评估，以确定疾病的部位和范围以及相邻区域的受累模式。
最常见的临床表现为鼻塞、流涕和鼻出血。单侧鼻腔受累16例，双侧鼻腔包括鼻中隔受累5例，鼻后孔受累3例。鼻腔外扩展部位包括肿瘤扩展至鼻窦（n=15）、鼻咽（n=5）、鼻唇沟（n=3）、口咽（n=2）、颞下窝（n=2）、面部其他皮下软组织（n=2）和前颅窝底（n=1）。18例显示骨质破坏，累及鼻窦骨壁（n=15）、鼻甲（n=10）、纸样板（n=6）、眶底（n=3）和硬腭（n=2）。3例鼻NK/T细胞淋巴瘤患者还检测到区域淋巴结肿大。
鼻NK/T细胞淋巴瘤的CT和MR表现无特异性，诊断需要组织学证实。然而，如果图像显示鼻腔软组织伴有骨质侵蚀或破坏；眼眶、鼻咽和颞下窝受累；以及皮下或鼻唇沟软组织浸润，尤其是在亚洲人群中，应考虑鼻NK/T细胞淋巴瘤的鉴别诊断。
