鼻咽癌治疗后并发鼻NK/T淋巴瘤1例的临床表现及诊断分析

Clinical manifestation and diagnosis of nasopharyngeal carcinoma complicated with nasal NK/T lymphoma after treatment

报道一例鼻咽癌患者化疗6年后并发鼻NK/T淋巴瘤。入院前5个月患者开始出现鼻阻、流脓涕,并逐渐出现发热。查体见右侧鼻背部明显红肿,表面痂壳附着,去除痂壳后见火山样溃疡,表面坏死组织附着。右侧鼻腔外侧壁向中线膨隆,大量白色假膜附着,不易剥离。右侧下鼻甲溃烂,易出血。右侧硬腭后份及软腭膨隆,骨质欠连续。鼻背部及鼻咽部新生物反复多次取活组织检查及免疫组织化学检查明确诊断为鼻NK/T淋巴瘤。复习文献表明鼻咽癌和鼻NK/T淋巴瘤的发病均与EBV密切相关,由此推测二者的相继发病与EBV感染有关。

Reported a case of nasopharyngeal carcinoma complicated with nasal NK/T lymphoma 6 years after chemotherapy.The patient began to develop nasal obstruction,purulent nasal discharge and fever in 5 months at baseline.Examination revealed obvious redness and swelling of the right nasal back and adherence of crust on the surface.Volcanic ulcer and adherence of necrotic tissue on the surface were found after crust removal.The lateral wall of the right nasal cavity bulged toward the midline,and a large number of white pseudo membranes were attached and were not easy to peel off.The right inferior turbinate was ulcerated and easy to bleed.The posterior part of the right hard palate and the soft palate were swollen,and the bone was not continuous.Nasal NK/T lymphoma was definitely diagnosed by repeated biopsy and immunohistochemical examination of nasal back and nasopharynx new organisms.Review of the literature showed that the incidence of nasopharyngeal carcinoma and nasal NK/T lymphoma were closely related to EBV,thus it was speculated that the successive incidence of nasopharyngeal carcinoma and nasal NK/T lymphoma was related to EBV infection.