Wajima Daisuke, Nishimura Fumihiko, Masui Katsuya
Department of Neurosurgery, Nara Medical University, Shijo-Cho, Kashihara, Nara, Japan.
Surg Neurol Int. 2020 Jul 25;11:208. doi: 10.25259/SNI_280_2020. eCollection 2020.
Non-Hodgkin lymphomas (NHLs) in paranasal sinus are uncommon, accounting for 0.17-2% of all NHL cases; it is especially rare in the sphenoid sinus. In this report, we describe a case of NHL in the sphenoid sinus.
A 66-year-old man presented with a sudden left eye movement disorder. His head computed tomography and gadolinium-enhanced magnetic resonance imaging (Gd-MRI) showed a mass lesion extending around the left sphenoid sinus. However, the tumor regrowth about twice was observed during 2 weeks, partial removal of tumor was performed by the endoscopic trans-nasal transsphenoidal surgery, then histologically proved it to be diffuse large B-cell lymphoma (DLBCL). After R-THP-COP regimen (rituximab 375 mg/m,cyclophosphamide 750 mg/m, epirubicin 50 mg/m, vincristine 2 mg/day, and prednisolone 100 mg/day) and two courses of intrathecal methotrexate therapy for DLBCL, the symptoms and the lesion of enhanced Gd-MRI and fluorodeoxyglucose-positron emission tomography were completely disappeared.
NHLs in the sphenoid sinus is very rare disease, however, it is important to be diagnosed pathologically as soon as possible for being in remission state by the chemotherapy.
鼻窦非霍奇金淋巴瘤(NHL)并不常见,占所有NHL病例的0.17 - 2%;在蝶窦中尤为罕见。在本报告中,我们描述了一例蝶窦NHL病例。
一名66岁男性出现突发左眼运动障碍。他的头部计算机断层扫描和钆增强磁共振成像(Gd - MRI)显示左侧蝶窦周围有一肿块病变。然而,在2周内观察到肿瘤大约复发了两次,通过鼻内镜经蝶窦手术对肿瘤进行了部分切除,随后组织学证实为弥漫性大B细胞淋巴瘤(DLBCL)。在接受R - THP - COP方案(利妥昔单抗375 mg/m²、环磷酰胺750 mg/m²、表柔比星50 mg/m²、长春新碱2 mg/天和泼尼松龙100 mg/天)以及针对DLBCL的两个疗程鞘内甲氨蝶呤治疗后,Gd - MRI增强和氟脱氧葡萄糖 - 正电子发射断层扫描的症状及病变完全消失。
蝶窦NHL是一种非常罕见的疾病,然而,通过化疗使其处于缓解状态,尽早进行病理诊断很重要。