Delayed Diagnosis of a Nasal Type Lymphoma Misdiagnosed as Persistent Sinusitis

J Adolesc Young Adult Oncol. 2017 Jun;6(2):381-384. doi: 10.1089/jayao.2016.0050. Epub 2017 Jan 6.

Abstract

Nasal Type T/natural killer (NK)-cell lymphomas are rare clinical entities, highly aggressive with a very poor prognosis. We present a case of a 37-year-old immunocompetent man presenting with deep palatal ulceration and a 3-month history of symptoms, which appear to have been misdiagnosed by physicians. The final diagnosis was achieved by a 15-day diagnostic algorithm, during which time the clinical status of the patient worsened severely. In this article, we also provide a succinct update on the clinical and histopathological findings of Peripheral T/NK-cell lymphomas and propose that symptoms that are consistent with these clinical entities should be considered from the early stages to inform a suitable diagnostic pathway Because of their highly aggressive behavior, we suggest that early therapy of T/NK-cell lymphomas may be started before completing the specific diagnostic investigations.

Keywords: NHL; lymphoma; nasal type lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Asparaginase / administration & dosage
  • Chronic Disease
  • Delayed Diagnosis*
  • Dexamethasone / administration & dosage
  • Diagnostic Errors*
  • Etoposide / administration & dosage
  • Fistula
  • Humans
  • Ifosfamide / administration & dosage
  • Leucovorin / administration & dosage
  • Lymphoma, Extranodal NK-T-Cell / diagnosis*
  • Lymphoma, Extranodal NK-T-Cell / pathology
  • Lymphoma, Extranodal NK-T-Cell / therapy
  • Male
  • Maxillary Sinusitis / diagnosis*
  • Methotrexate / administration & dosage
  • Mouth Diseases
  • Nose Diseases
  • Nose Neoplasms / diagnosis*
  • Nose Neoplasms / pathology
  • Nose Neoplasms / therapy
  • Palatal Neoplasms / diagnosis*
  • Palatal Neoplasms / pathology
  • Palatal Neoplasms / therapy
  • Radiotherapy

Substances

  • Etoposide
  • Dexamethasone
  • Asparaginase
  • Leucovorin
  • Ifosfamide
  • Methotrexate