Rzadki przypadek chłoniaka złośliwego zatoki czołowej objawiający się w postaci pyocele

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Lymphoma (mostly NHL) accounts for 3–5% of all malignant tumors. Only 0.17–2% of lymphoma localizes in the sinonasal tract. Lymphoma of the frontal sinus is extremely rare. The symptoms are often nonspecific and differentiating between inflammatory and neoplastic changes of the frontal sinus is very difficult. The aim of this study was to present a case of a patient operated on because of the left frontal sinus pyocele with orbital complication, in which histopathological examination revealed the presence of malignant lymphoma. The complication of sinusitis was suspected because of the rapid development of symptoms in the formerly healthy patient. The CT and MRI revealed erosion of the anterior and posterior table of the frontal bone and the roof of the orbit and the pathological mass of the frontal sinus penetrating into the orbit. The infected mucocele was initially diagnosed. Histopathologic analysis of the mass removed by the external approach revealed diffuse large B-cell lymphoma. The differential diagnosis of the sinus pathology with bone destruction should include malignant tumors, including lymphomas, despite their rarity in this area. The external approach to the frontal sinus affords good visualization and taking the appropriate material for histopathology, which is crucial for the final diagnosis. In the case of malignant lymphoma of the frontal sinus ENT role is limited to the collection of material and treatment of potential inflammatory complications.