Characteristics of Extranodal NK/T-Cell Lymphoma, Nasal Type, Compared with Nasal Diffuse Large B-cell Lymphoma

Abstract

Background: Extranodal NK/T-cell lymphoma, nasal type (ENKL), is an aggressive tumour with poor prognosis. Its early diagnosis may improve the prognosis of patients; however, it is often overlooked in many cases and misdiagnosed as an inflammatory sinus disease during its initial stage. Identifying the clinical characteristics of ENKL may aid otorhinolaryngologists in indicating cases early for a pathologic examination. In this study, we aimed to investigate the clinical characteristics of ENKL compared with that of diffuse large B-cell lymphoma (DLBCL), which is the most common nasal malignant lymphoma. Methods: The backgrounds, clinical symptoms, blood test results, and computed tomography images of patients with nasal/paranasal malignant lymphoma in our hospital between 2012 and 2017 were investigated. The characteristics of ENKL and nasal DLBCL were compared to differentiate them. Results: A total of 27 patients with nasal cavity and/or paranasal sinus lymphoma were included. Extranodal NK/T-cell lymphoma, nasal type, was diagnosed in 10 patients, while DLBCL was diagnosed in 17 patients. The median age of patients with ENKL was significantly lower than that of patients with DLBCL. All patients with ENKL had a unilateral lesion in the nasal cavity, with most located at the inferior turbinate. They also experienced nasal symptoms with significantly higher incidence of nasal obstruction and tendency of bleeding. Conclusion: ENKL was often unilateral and caused nasal obstruction, unlike DLBCL. Those who are younger in age and have sinonasal tumour with unilateral nasal obstruction and bleeding should be considered for early and repeated biopsies at multiple sites, with ENKL taken into consideration.

Clinical characteristics analysis of sinonasal diffuse large B‐cell lymphoma and extranodal NK/T‐cell lymphoma

“…2,3 As in other studies, ENKL caused more nasal symptoms than DLBCL, probably because it occurred in the nasal cavity (p < 0.05). [2][3][4] However, both DLBCL and ENKL exhibit similar symptoms to chronic sinusitis, making it impossible to differentiate based on symptoms. [1][2][3][4][5] In this study, ENKL demonstrated a smaller size than DLBCL, because it occurred in the nasal cavity and symptoms developed quickly (p < 0.05).…”

“…DLBCL is the most common lymphoma arising in the nasal cavity and paranasal sinuses. [1][2][3][4][5][6] However, the incidence of ENKL was higher in this study, probably because only Asians were included. 6 ENKL occurred at a younger age than DLBCL (p < 0.05).…”

“…[2][3][4] However, both DLBCL and ENKL exhibit similar symptoms to chronic sinusitis, making it impossible to differentiate based on symptoms. [1][2][3][4][5] In this study, ENKL demonstrated a smaller size than DLBCL, because it occurred in the nasal cavity and symptoms developed quickly (p < 0.05). Moreover, ENKL was diagnosed earlier and appeared to have a lower Ann Arbor stage (p < 0.05).…”

“…The most common types of sinonasal lymphoma are diffuse large B-cell lymphoma (DLBCL) and extranodal natural killer/T-cell lymphoma (ENKL). [1][2][3][4][5][6] However, DLBCL and ENKL differ from each other in several aspects, including race, region of prevalence, treatment, and prognosis. [3][4][5][6] Therefore, we analyzed the clinical differences between DLBCL and ENKL diagnosed at our hospital.…”

“…[1][2][3][4][5][6] However, DLBCL and ENKL differ from each other in several aspects, including race, region of prevalence, treatment, and prognosis. [3][4][5][6] Therefore, we analyzed the clinical differences between DLBCL and ENKL diagnosed at our hospital.…”