Non-Hodgkin lymphoma

Primary non-Hodgkin
lymphoma of the sinonasal cavity has a variable and nonspecific
appearance, but should be considered high among
differential possibilities when the abnormal soft tissue
involving the nasal cavity, the paranasal sinuses, or both is
diffuse and infiltrative, often involving multiple locations,
rather than presenting as a dominant mass lesion.

When a lymphoma simply presents as a mass lesion, it can-
not be confidently distinguished from many other sinonasal
pathologies without tissue sampling. Lymphomas of
T-cell origin predominate in the nasal cavity, whereas those
of B-cell origin predominate in the paranasal sinuses. Nasal
natural killer (NK)/T-cell lymphoma should be specifically
considered when there is diffuse involvement of the nasal
cavity, often accompanied by necrosis and midline destruction.

Recall that the differential diagnosis of midfacial
destruction includes Wegener granulomatosis, sarcoidosis,
cocaine abuse, and infection (eg, syphilis, tuberculosis, leprosy,
and fungus), as well as NK/T-cell lymphoma.


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