原发性鼻腔、鼻窦结外非霍奇金淋巴瘤28例临床分析

Primary extranodal non-Hodgkin's lymphoma in nasal cavity and sinuses(a clinical repot of 28 cases)

目的总结原发性鼻腔、鼻窦结外非霍奇金淋巴瘤的临床特点,探讨其有效诊疗方法。方法回顾性研究本院诊疗的原发性鼻腔、鼻窦结外非霍奇金淋巴瘤28例,分析其临床表现特点、误诊原因、病理特点及影像学特征,总结提高诊疗效果的途径。结果原发性鼻腔、鼻窦结外非霍奇金淋巴瘤临床表现复杂,缺乏特异性,误诊误治率高达78.5%,其影像学特征有助于本病的诊断及病变范围评估。结论原发性鼻腔、鼻窦结外非霍奇金淋巴瘤容易误诊误治,全面分析其临床表现、及早或多次病灶活检是减少误诊的重要途径。

Objective To sum up the clinical features of primary non-Hodgkin＇s lymphoma in nasal cavity and sinuses to explore more feasible performing procedures for the diagnosis and treatment of this kind of lesion based on a clinical analysis on a group of cases. Methods A retrospective study was carried out among 28 patients with primary extranodal non-Hodgkin＇s lymphoma in nasal cavity and sinuses treated in our Hospital during recent years. Careful analysis was made on their clinical features, causes underlying the misdiagnosis made during their diagnostic and therapeutic course undergone before, characters in histopathology, and special manifestations in X-ray and CT images. Then, exploration was made to find more appropriate approaches for the diagnosis and treatment of the lesion based on these data. Results This study demonstrated that the clinical presentations of primary extranodal non-Hodgkin＇s lymphoma in nasal cavity and sinuses were very complicated, with no obvious specific and simple clinical features supporting a definite diagnosis for this condition. Therefore, there was a much higher rate of misdiagnosis happened before, perhaps to such a high level of 78.5%. In spite of this, identification on the features of X-ray and CT images was much significantly contributed to the diagnosis and evaluation on the extension of the lesion. Conclusions Although misdiagnosis has been more frequently occurred in clinical practice so as to lead taking an un-appropriate therapeutic strategy for this lesion among some cases, very important is that focused attention should be given on a careful analysis on the clinical presentations of such patients, followed by earlier, sometimes maybe repeated, biopsy to the focus to make a right diagnosis for primary extranodal non-Hodgkin＇s lymphoma in nasal cavity and sinuses.