鼻NK/T细胞淋巴瘤20例临床及病理特征分析

Clinical and pathohistological characteristics of nasal NK/T cell lymphoma-with 20 cases report

目的探讨鼻NK/T细胞淋巴瘤的临床及组织病理学特征。方法对20例鼻腔NK/T细胞淋巴瘤患者临床资料进行回顾性分析,总结其临床特点及组织病理学特征。结果患者早期主要临床症状表现为单侧鼻塞及脓血涕;晚期表现为鼻腔恶臭、坏死及发热。经鼻内镜检查,早期粘膜肿胀,分泌物增多;晚期粘膜坏死覆脓痂,质脆伴异味。CT显示13例肿瘤居于鼻腔前部,6例居于鼻中隔;14例病变累及上颌窦,3例累及筛窦,5例同时累及上颌窦与筛窦。病理学免疫组化染色表达NK相适抗原和T细胞分化抗原。结论本病临床表现缺乏特异性,CT检查有利于确定病变范围及临床分期,取材活检及免疫组织化学检查是确诊鼻NK/T细胞淋巴瘤的主要依据。

Objective To sum up the clinical and pathohistological characteristics of nasal NK/T cell lymphoma based on a clinical survey on a group of cases with this kind of lesion. Methods A retrospective study was carried out among 20 cases with nasal NK/T cell lymphoma,treated in our Hospital from Jan. 2001 to Dec. 2010 ,to sum up the clinical and pathohistological characteristics of this condition. Results The most commonly seen clinical symptoms included the unilateral nasal obstruction accompanied with bloodish purrelant nasal discharge in patients with early stage;and nasal odor, necrosis and fever in patients with late stage. By nasal endoscopy,it was founded that mucosal swelled, secretions increased in early stage, and mucosa necrosis overlyed by crest of pus, britte with peculiar smell in late stage. From the CT film. it was shown that the lesion localized in the anterior nasal cavity in 13 patients and derived from septum in 6, with 14 limited in maxillary sinus,3 involved in ethmoidal sinuses and 5 reached al a range including both of maxillary and ethmoidal sinuses. However, NK suitable antigen and T cell differentiation antigens were pathohistologically expressed by iminunohistochemistry. Conclusion It is somewhat troublesome that this kind of lesion is lacking disease-specific features for making a more definite clinical diagnosis simply based on its manifestations, while CT scanning may be helpful for evaluating the involved range of lesion and decision making in its clinical phase. Only on the basis of pathohistology made on tissue samples from a biopsy in muhiple locations and on the basis of accessory assay by immunobistoehemistry to provide powerful videnees, Can a final diagnosis be made for such a conditionas nasal NK/T cell lymphoma.