Clinical Analysis Of Primary Nasal And Sinus Non-Hodgkin's Lymphoma

Objective:To discuss the clinical characteristics and pathological features of the primary sinonasal non-Hodgkin's lymphoma.Methods:A group of clinical data of 15 inpatients suffering from non-Hodgkin's lymphoma on nasal cavity and paranasal sinuses during 2000-2005 was analyzed retrospectively.Results:in the 15 cases,there are 10 males and 5 females,the ratio of male to female was 2:1.The ages of the patients were ranged from 14 to 66,and their average age was 45 years old.The courses were in 2 to 9 months,with an average of 4.2 months.Clinical manifestations included nasal obstruction,more nasal mucus,nose bleeding,headache and fever.By Ann Arbor stage,13 cases were in Stageâ… ,1 in Stageâ…¡and 1 in Stageâ…£.Six of them showed the Group B symptoms(fever,night sweats,weight loss).In the 12 immunohistochemical examination,8 cases were T-cells lymphoma,2 cases were B-cells lymphoma,and the other 2 cases were NK/T-cell lymphoma.NK/T-cell lymphoma showed the vascular center,vascular infiltration and necrosis,but the T-cell lymphoma and B-cell lymphoma didn't show the similar symptom.In the 15 cases,8 cases were misdiagnosed;the rate of misdiagnosis was high to 53%. Reasons of misdiagnosis were lack of awareness of the disease,fluorescein isothiocyanate misconduct,Not careful inspection Imaging studies were not specific.In the 8 radiotherapy combined with chemotherapy treatment cases,6 cases were complete remission(CR)and 2 were partial remission(PR).In the 4 radiotherapy cases,3 cases were complete remission(CR) and 1 was partial remission(PR).In the chemotherapy 2 cases,1 was complete remission(CR) and the other one was partial remission(PR).The one case treated by surgery combined with radiotherapy and chemotherapy was complete remission.The clinical data was analyzed by SPSS 10.0 with small samples of the Kaplan-Meier survival statistics.5-year survival rate was 52.1%.Conclusions:Nasal lymphoma mainly from T-cells,B-cells,NK/T-cell.There was no special clinical manifestations.Nasal obstruction and epistaxis were two main clinical manifestations.In early stage,it was difficult to identify with chronic rhinitis,sinusitis and other diseases.There was also no specificity in imaging studies,so it was easily missed diagnosis and misdiagnosed.Clinical doctors should pay more attention to raising awareness,in order to prevent being missed diagnosis and misdiagnosed.Timely live histopathological examination may be a diagnosis key.