Sinonasal Non-Hodgkin's Lymphoma in Patients Infected with Human Immunodeficiency Virus: Report of Three Cases and Review

Abstract

Non-Hodgkin's lymphoma (NHL) is a frequent complication of human immunodeficiency virus (HIV) infection, but involvement of the sinonasal region has only rarely been reported. We report three cases of AIDS-associated sinonasal NHL that occurred at our institution and review eight cases that were reported in the literature. The epidemiological and clinicopathologic features of these cases are described and compared with those of three other groups of patients: non-HIV-infected patients with sinonasal NHL, HIV-infected patients with NHL of any anatomic site, and HIV-infected patients with infectious sinusitis. Patients with AIDS-associated sinonasal NHL more frequently developed bony erosion and presented with signs and symptoms referable to adjacent structures, such as the orbit, than did HIV-infected patients with sinusitis, and patients with AIDS and NHL less frequently had typical sinus symptoms and diffuse sinus involvement than did patients with sinusitis. However, the clinical manifestations of these conditions overlap; thus a high index of suspicion for NHL is imperative for prompt diagnosis. These lymphomas typically are high-grade and disseminate early, and the prognosis is generally poor.

Invasive Aspergillus Sinusitis in Human Immunodeficiency Virus Infection: Case Report and Review of the Literature

“…Sinonasal mucormycosis is also clinically indistinguishable from Aspergillus , and it warrants the empiric use of amphotericin B until the causative pathogen is confirmed [1, 46, 47]. In the patient with advanced HIV infection, additional etiologies include Cryptococcus [48], Candida [49], Scedosporium [50], nontuberculous mycobacteria [22], and malignancies such as non-Hodgkin's lymphoma [51]. …”

Herpesvirus type 1–8 in BAL fluid from HIV-1-infected patients with suspected pneumonia and from healthy individuals

“…EBV seems to be related to the development of AIDSassociated nonHodgkin9s lymphoma (NHL) [19]. STOPYRA et al [20] concluded that primary infection or reactivation of EBV is probably an under-reported cause of morbidity and mortality in AIDS patients.…”

Lymphomas of the Head and Neck

“…It predominantly affects middle-aged or older adults [58][59][60]81 and occasionally affects children. 59 A few patients have been HIV positive 59,82 or iatrogenically immunosuppressed. 59,83 Symptoms include nasal obstruction or discharge, facial pain or swelling, numbness, epistaxis, sinus pressure, toothache, or headache.…”

“…The lymphoma may invade adjacent structures, such as the orbit, base of the skull, central nervous system (CNS), pterygopalatine fossa, nasopharynx, and palate. 60,82,84 In these cases, the patient may present with neurologic abnormalities, proptosis, diplopia, decreased visual acuity, and even blindness. 58,59,82,[85][86][87][88] Patients occasionally have fever and night sweats.…”

“…60,82,84 In these cases, the patient may present with neurologic abnormalities, proptosis, diplopia, decreased visual acuity, and even blindness. 58,59,82,[85][86][87][88] Patients occasionally have fever and night sweats. 59,82 Among the paranasal sinuses, the maxillary sinus is the most common site of involvement, followed by the ethmoid sinus, sphenoid sinus, and frontal sinus.…”