Han Yi-Jing, Huang Wen-Peng, Gao Jian-Bo, Yang Zhi-Hao
Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No.1 Eastern Jianshe Road, Zhengzhou, 450052, China.
Radiol Case Rep. 2021 Dec 30;17(4):1354-1358. doi: 10.1016/j.radcr.2021.10.036. eCollection 2022 Apr.
Extranodal nasal NK/Tcell lymphoma (ENKTCL) is a relatively rare type of non-Hodgkin's lymphoma. It is highly malignant, highly invasive, and easy to relapse. Most patients have a poor prognosis. We report a 48-year-old woman who presented with irritant dry cough that had persisted for 6 m. CT showed a mass in the right nasal cavity, with uneven density similar to soft tissue, with slight uneven enhancement. The mass and the upper, middle, and lower turbinates were not clearly demarcated, involving multiple adjacent sinus cavities, and the local bone showed osteolytic destruction; MRI showed isosignal on T1WI and slightly hypersignal on T2WI and DWI. In addition, there was a mass of soft tissue density at the bronchial opening in the right middle lobe, showing uneven and obvious enhancement; a cavity was seen in the nodule of the right lower lobe, and the adjacent pleura was stretched, showing moderate enhancement. The nasal mass was diagnosed as extranodal NK/T cell lymphoma, the right middle lobe mass was diagnosed as mucoepidermoid carcinoma, and the right lower lobe mass was diagnosed as lung adenocarcinoma. ENKTCL rarely invades the lungs. If a patient has a lung occupying lesion similar to it, biopsy confirmation should be considered to avoid misdiagnosis as a chest metastasis that affects the treatment effect.
结外鼻型NK/T细胞淋巴瘤（ENKTCL）是一种相对罕见的非霍奇金淋巴瘤。它具有高度恶性、高度侵袭性且易于复发。大多数患者预后较差。我们报告一名48岁女性，她出现刺激性干咳，持续6个月。CT显示右侧鼻腔有一肿块，密度不均匀，类似软组织，强化略有不均匀。肿块与上、中、下鼻甲分界不清，累及多个相邻鼻窦腔，局部骨质呈溶骨性破坏；MRI显示T1WI上等信号，T2WI和DWI上略高信号。此外，右中叶支气管开口处有一软组织密度肿块，强化不均匀且明显；右下叶结节内见空洞，相邻胸膜牵拉，呈中度强化。鼻腔肿块诊断为结外NK/T细胞淋巴瘤，右中叶肿块诊断为黏液表皮样癌，右下叶肿块诊断为肺腺癌。ENKTCL很少侵犯肺部。如果患者有类似的肺部占位性病变，应考虑活检确诊，以避免误诊为胸部转移而影响治疗效果。
