Yoon Seokho, Ryu Kyeong Hwa, Baek Hye Jin, An Hyo Jung, Joo Yeon-Hee
Department of Nuclear Medicine and Molecular Imaging, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon 51472, South Korea.
Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon 51472, South Korea.
World J Clin Cases. 2021 Mar 6;9(7):1654-1660. doi: 10.12998/wjcc.v9.i7.1654.
Primary non-Hodgkin's lymphoma of the frontal sinus is extremely rare. In addition, Epstein-Barr virus (EBV) has been reported to play a role in the development of human immunodeficiency virus (HIV)-related malignant lymphomas. To the best of our knowledge, there is no report for the HIV-associated, EBV-positive primary diffuse large B-cell lymphoma (DLBCL) in the frontal sinus.
We present a unique case of HIV-associated, EBV-positive DLBCL in the frontal sinus in a 46-year-old man. Computed tomography of paranasal sinuses revealed dense opacification of the right frontal sinus with combined soft tissue swelling. Based on the clinical and radiological findings, the initial diagnosis was complicated frontal sinusitis, presenting Pott's puffy tumor. Unexpectedly, HIV testing was positive on preoperative laboratory test, and the frontal sinus lesion was confirmed as EBV-positive DLBCL on biopsy.
Through this article, we suggest that EBV-positive DLBCL should be considered as possible diagnosis for patients with nonspecific space-occupying lesion of the paranasal sinuses. We also highlight an importance of clinical suspicion in diagnosing HIV infection because HIV serology is not routinely tested in patients with paranasal sinus problem.
额窦原发性非霍奇金淋巴瘤极为罕见。此外,据报道,爱泼斯坦-巴尔病毒(EBV)在人类免疫缺陷病毒(HIV)相关恶性淋巴瘤的发生中起作用。据我们所知,尚无关于HIV相关、EBV阳性的额窦原发性弥漫性大B细胞淋巴瘤(DLBCL)的报道。
我们报告一例46岁男性患者,患有HIV相关、EBV阳性的额窦DLBCL。鼻窦计算机断层扫描显示右侧额窦致密混浊并伴有软组织肿胀。根据临床和影像学检查结果,初步诊断为复杂性额窦炎,表现为波特氏浮肿性肿瘤。出乎意料的是,术前实验室检查HIV检测呈阳性,活检证实额窦病变为EBV阳性DLBCL。
通过本文,我们建议对于鼻窦非特异性占位性病变患者,应考虑EBV阳性DLBCL的可能诊断。我们还强调了临床怀疑在诊断HIV感染中的重要性,因为鼻窦问题患者通常不常规进行HIV血清学检测。