Clinical and diagnosis analysis of malignant lymphoma in nasal cavity and paranasal sinus
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摘要: 目的:探讨鼻腔鼻窦恶性淋巴瘤临床特点、影像学特征、病理类型、误诊原因及其早期的诊断方法。方法:对34例鼻腔鼻窦恶性淋巴瘤临床病理资料进行回顾性分析。结果:鼻腔鼻窦恶性淋巴瘤好发于中年男性,发病率占同期鼻部恶性肿瘤的21.7%(34/157),鼻腔发病率(76.5%)明显高于鼻窦(17.6%)。首发症状主要表现为鼻塞、鼻出血、脓涕及发热等;体征主要表现为鼻腔新生物、鼻腔黏膜充血、糜烂、坏死及面部肿胀等;CT主要表现为病变部位在鼻腔前部和前中部,密度较均匀,可伴有软组织肿胀,骨质破坏少而轻;鼻腔淋巴瘤以NK/T细胞淋巴瘤为主,占61.5%(16/26),鼻窦淋巴瘤以B细胞淋巴瘤为主,占83.3%(5/6)。该病误诊率为21.2%。结论:鼻腔鼻窦恶性淋巴无特异性临床特征,CT影像具有一定的特征性,综合临床症状和体征、影像及病理特点,可提高对该病的认识及诊断准确率。Abstract: Objective: To investigate the clinical features, imaging characteristics, pathological types, the misdiagnosis causes and the early diagnosis method of malignant lymphoma in nasal cavity and paranasal sinuses.Method: Clinicopathological data of 34 patients with malignant lymphoma in nasal cavity and paranasal sinuses were retrospectively analyzed.Result: Most of patients were middle aged man, the incidence of malignant lymphoma of nasal cavity and paranasal sinuses accounted for 21.7% of nasal malignant tumor over the same period, nasal malignant lymphoma incidence rate was higher than the sinus malignant lymphoma (76.5%VS.17.6%). The main symptoms were presented as snuffle, epistaxis, purulent nasal discharge, fever and so on. Nasal neoplasm, nasal mucosa hyperemia, erosion, necrosis are the main signs of the disease. CT features were summarized as the lesions located in the anterior-middle area in nasal cavity, homogeneous in density, soft tissue swelling in some cases and less bone destruction. The majority pathological type of nasal malignant lymphoma was NK/T cell lymphoma, but the common pathological type of paranasal sinus malignant lymphoma was B-cell lymphoma. The misdiagnosis rate of malignant lymphoma in nasal cavity and paranasal sinus was 21.2%.Conclusion: Malignant lymphoma in nasal cavity and paranasal sinuses without specific clinical characteristics, but has some certain CT characteristics. Combined with the clinical, imaging and pathological features, can improve the cognition and diagnosis of the disease.
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Key words:
- malignant lymphoma /
- nasal cavity /
- paranasal sinus /
- clinical characteristics
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