A Rare and Challenging Entity: Sino-Nasal Nk/T-Cell Lymphoma

Abstract

Extranodal NK/T-cell lymphomas are a rare subtype of non-Hodgkin’s lymphomas. They represent a diagnostic challenge due to their clinical presentation polymorphism and to the abundance of the necrotic tissues on biopsies. We report the case of a male patient that initially presented with chronic facial and palatine pain, associated to a palatine substance loss and a jugal edema on physical examination. Facial CT scan showed the lesion and its extension to the nasopharynx and association to multiple cervical lymph nodes. Initial biopsies have erred the diagnosis showing signs of a mycotic infection with no malignant cells. Considering the bad response to anti-fungal treatment, biopsies and radiological explorations were redone and were in favor of a NK/T-cell lymphoma. Locoregional and distant extensions of the disease were studied, showing an hepatic suspicious nodule and mediastinal lymph nodes. Then, the patient underwent sequential chemo and radiotherapy with a good response to treatment.