Sharma A, Dandekar M, Deshmukh S, Dabholkar J
Department of Otorhinolaryngology and Head-Neck Services, Seth G S Medical College, King Edward VII Memorial Hospital, Mumbai, India.
J Laryngol Otol. 2011 Nov;125(11):1181-4. doi: 10.1017/S0022215111001617. Epub 2011 Jul 7.
We report two cases of nasal natural killer T cell lymphoma which presented atypically following surgical intervention.
Two patients with a previous history of endoscopic nasal surgery presented with progressive facial swelling and necrosis. The histology of several nasal biopsies was suggestive of acute, necrotising inflammation. Considering these patients' midline destruction of the nose and face, and their inconclusive biopsies, immunohistochemical studies were undertaken, enabling the diagnosis of peripheral natural killer T cell lymphoma.
Natural killer T cell lymphoma of the sinonasal tract is an important differential diagnosis of destructive lesions of the nose and midface. The definitive diagnosis is often delayed. Hence, this tumour should be considered in patients with atypical presentations of acute inflammation following surgical intervention; such patients should be thoroughly investigated. Early immunohistochemical investigation is needed to enable prompt diagnosis in suspicious cases.
我们报告两例鼻腔自然杀伤T细胞淋巴瘤，其在手术干预后表现不典型。
两名有内镜下鼻腔手术史的患者出现进行性面部肿胀和坏死。多次鼻腔活检的组织学表现提示为急性坏死性炎症。考虑到这些患者鼻面部的中线破坏以及活检结果不明确，进行了免疫组化研究，从而确诊为外周自然杀伤T细胞淋巴瘤。
鼻窦自然杀伤T细胞淋巴瘤是鼻和中面部破坏性病变的重要鉴别诊断。确诊往往延迟。因此，对于手术干预后出现急性炎症非典型表现的患者应考虑到这种肿瘤；此类患者应进行全面检查。对于可疑病例，需要早期进行免疫组化检查以便及时诊断。
