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Zhang Z, Ma Z, Zhang L, Zheng K, Hou L. Primary Plasmablastic Lymphoma of The Paranasal Sinuses: A Rare Case Report. EAR, NOSE & THROAT JOURNAL 2023:1455613231213545. [PMID: 38032063 DOI: 10.1177/01455613231213545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Plasmablastic lymphoma (PBL) is a rare and highly invasive type of non-Hodgkin's lymphoma. It is usually associated with immunosuppression and human immunodeficiency virus infection. PBL most commonly occurs in the oral cavity, lymph nodes, and in other extranodal sites. However, it rarely originates from bilateral sinuses. Herein, we report the case of a 59-year-old man diagnosed with primary PBL of the sinuses confirmed by endoscopic biopsy, imaging materials, histopathological examination, and immunohistochemistry. The patient underwent 4 cycles of chemotherapy and 22 rounds of radiation therapy for 8 months. Re-examination by sinus computed tomography revealed no obvious tumor tissue in the nasal cavity and sinuses, suggesting that treatment was effective. No local recurrence or distant metastasis was detected at 6-month follow-up after the end of treatment.
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Affiliation(s)
- Zhijuan Zhang
- Department of Otolaryngology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Zheng Ma
- Department of Otolaryngology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Liping Zhang
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, China
| | - Kaizhi Zheng
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Li Hou
- Department of Otolaryngology, General Hospital of Ningxia Medical University, Yinchuan, China
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2
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Suthersan S, Periasamy C, Noh KB, Lee SK, Husain S. Sphenoid Lymphoma: A Diagnostic Challenge. Cureus 2023; 15:e41058. [PMID: 37519496 PMCID: PMC10374976 DOI: 10.7759/cureus.41058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Sphenoid sinus lesions grasp the attention of Otorhinolaryngologists due to their prime location and vital surrounding structures. Once detected, these lesions require prompt investigation to identify the underlying cause, usually attributed to a tumor, fungal infection, sinusitis, or polyps, thus allowing tailored treatment. We report a case of an elderly lady whose neurological presentation lead to the diagnosis of sphenoid sinus lymphoma. We discuss the diagnostic challenge in view of its interesting presenting symptoms as well as the surgical approach risk and limitations.
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Affiliation(s)
- Shasikala Suthersan
- Department of Otorhinolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | | | - Khairul Bariah Noh
- Department of Otorhinolaryngology - Head and Neck Surgery, Hospital Sultanah Bahiyah, Alor Setar, MYS
| | - Suk Kam Lee
- Department of Pathology, Penang General Hospital, Penang, MYS
| | - Salina Husain
- Department of Otorhinolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
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3
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Juniat V, Cameron CA, Roelofs K, Bajic N, Patel S, Slattery J, Davis G, Rootman D, Selva D. Radiological analysis of orbital lymphoma histological subtypes. Orbit 2023; 42:59-67. [PMID: 35192428 DOI: 10.1080/01676830.2022.2035772] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE To characterise the radiological features of orbital lymphoma subtypes. METHODS This was a multicentre, retrospective study to analyse radiological and clinical characteristics of orbital lymphoma by histological subtype across two sites within Australia and the United States. RESULTS A total of eighty-eight patients were included. The most common subtypes were extranodal marginal zone lymphoma [EMZL] (48, 54.5%), follicular lymphoma [FL] (16, 18.2%), and diffuse large B-cell lymphoma [DLBCL] (15, 17.0%). Clinically, significant associations were found between DLBCL and vision change (p < .01), pain (p < .01), extraocular movement limitation (p = .01), and optic neuropathy (p = .01). Radiologically, there was no significant difference between the individual histopathological sub-groups with respect to bone destruction (p = .30), optic nerve involvement (p = .30) and diffuse appearance (p = .84). However, if categorised as either aggressive or indolent, aggressive lymphoma subtypes were significantly more likely to demonstrate globe indentation radiologically than indolent subtypes (Odds Ratio = 5.5, 95% CI: 1.3, 23.3; p = .02). CONCLUSIONS DLBCL was significantly associated with vision change, pain, extraocular movement limitation and optic neuropathy clinically. Aggressive lymphoma subtypes were significantly more likely to demonstrate globe indentation radiologically. Otherwise, there were no significant differences between lymphoma subtypes and radiological findings on MRI and CT.
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Affiliation(s)
- Valerie Juniat
- South Australian Institute of Ophthalmology, The University of Adelaide and the Royal Adelaide Hospital Adelaide, Australia
| | - Cassie A Cameron
- South Australian Institute of Ophthalmology, The University of Adelaide and the Royal Adelaide Hospital Adelaide, Australia
| | - Kelsey Roelofs
- Division of Orbital and Ophthalmic Plastic Surgery, Stein Eye Institute of UCLA, Los Angeles, California, USA
| | - Nicholas Bajic
- Department of Medical Imaging, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Sandy Patel
- Department of Medical Imaging, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - James Slattery
- South Australian Institute of Ophthalmology, The University of Adelaide and the Royal Adelaide Hospital Adelaide, Australia
| | - Garry Davis
- South Australian Institute of Ophthalmology, The University of Adelaide and the Royal Adelaide Hospital Adelaide, Australia
| | - Daniel Rootman
- Division of Orbital and Ophthalmic Plastic Surgery, Stein Eye Institute of UCLA, Los Angeles, California, USA
| | - Dinesh Selva
- South Australian Institute of Ophthalmology, The University of Adelaide and the Royal Adelaide Hospital Adelaide, Australia
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4
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Bitner BF, Htun NN, Wang BY, Brem EA, Kuan EC. Sinonasal lymphoma: A primer for otolaryngologists. Laryngoscope Investig Otolaryngol 2022; 7:1712-1724. [PMID: 36544932 PMCID: PMC9764779 DOI: 10.1002/lio2.941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/28/2022] [Accepted: 09/20/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Sinonasal lymphomas are a rare entity that commonly present with nonspecific sinonasal symptoms and are often recognized immediately. Through this review, we aim to summarize important principles in diagnosis and treatment of sinonasal lymphomas, with the goal of disseminating the current knowledge of this under-recognized malignancy to otolaryngologists. Methods Systemic review using PRISMA guidelines of foundational scholarly articles, guidelines, and trials were reviewed focusing on clinical characteristics of key sinonasal lymphoma subtypes, along with available treatments in the otolaryngology, medical oncology, and radiation oncology literature. Results Sinonasal lymphoma are derived from clonal proliferation of lymphocytes at various stages of differentiation, of which diffuse large B-cell lymphoma (DLBCL) and extranodal natural killer/T-cell lymphoma (ENKTL) are the most common. Diagnosis and staging require biopsy with immunohistochemistry in conjunction with imaging and laboratory studies. Treatment is ever evolving and currently includes multi-agent chemotherapy and/or radiation therapy. Conclusion Otolaryngologists may be the first to recognize sinonasal lymphoma, which requires a comprehensive workup and a multidisciplinary team for treatment. Symptoms are nonspecific and similar to many sinonasal pathologies, and it is crucial for otolaryngologists to keep a broad differential. Level of Evidence 5.
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Affiliation(s)
- Benjamin F. Bitner
- Department of Otolaryngology – Head and Neck SurgeryUniversity of California Irvine Medical CenterOrangeCaliforniaUSA
| | - Nyein Nyein Htun
- Department of Pathology and Laboratory MedicineUniversity of California Irvine Medical CenterOrangeCaliforniaUSA
| | - Beverly Y. Wang
- Department of Pathology and Laboratory MedicineUniversity of California Irvine Medical CenterOrangeCaliforniaUSA
| | - Elizabeth A. Brem
- Department of Medicine, Division of Hematology and OncologyUniversity of California Irvine Medical CenterOrangeCaliforniaUSA
| | - Edward C. Kuan
- Department of Otolaryngology – Head and Neck SurgeryUniversity of California Irvine Medical CenterOrangeCaliforniaUSA,Department of Neurological SurgeryUniversity of California Irvine Medical CenterOrangeCaliforniaUSA
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5
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Maitra M, Singh MK. A Comparative Study on Clinico-radiological Differentiation of Sino-nasal Squamous Cell Carcinoma (SCC) and Sino-nasal Non-Hodgkins Lymphoma (NHL). Indian J Otolaryngol Head Neck Surg 2022; 74:142-145. [DOI: 10.1007/s12070-020-02091-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 08/24/2020] [Indexed: 10/23/2022] Open
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6
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Multimodality imaging of extra-nodal lymphoma in the head and neck. Clin Radiol 2022; 77:e549-e559. [DOI: 10.1016/j.crad.2022.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/22/2022] [Indexed: 11/19/2022]
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7
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Reginelli A, Urraro F, Sangiovanni A, Russo GM, Russo C, Grassi R, Agostini A, Belfiore MP, Cellina M, Floridi C, Giovagnoni A, Sica A, Cappabianca S. Extranodal Lymphomas: a pictorial review for CT and MRI classification. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:34-42. [PMID: 32945277 PMCID: PMC7944666 DOI: 10.23750/abm.v91i8-s.9971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022]
Abstract
Extranodal lymphomas represent an extranodal location of both non-Hodgkin and Hodgkin lymphomas. This study aims to evaluate the role of CT and MRI in the assessment of relationships of extranodal lymphomas with surrounding tissues and in the characterization of the lesion. We selected and reviewed ten recent studies among the most recent ones present in literature exclusively about CT and MRI imaging of extranodal lymphomas. Contrast-enhanced computed tomography (CT) is usually the first-line imaging modality in the evaluation of extranodal lymphomas, according to Lugano classification. However, MRI has a crucial role thanks to the superior soft-tissue contrast resolution, particularly in the anatomical region as head and neck. (www.actabiomedica.it)
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Affiliation(s)
- Alfonso Reginelli
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Fabrizio Urraro
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Angelo Sangiovanni
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Gaetano Maria Russo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Carolina Russo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Andrea Agostini
- Radiology Department, Università Politecnica delle Marche, Ancona, Italy.
| | - Maria Paola Belfiore
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
| | - Michaela Cellina
- Department of Radiology, Ospedale Fatebenefratelli, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Chiara Floridi
- Radiology Department, Università Politecnica delle Marche, Ancona, Italy.
| | - Andrea Giovagnoni
- Radiology Department, Università Politecnica delle Marche, Ancona, Italy.
| | - Antonello Sica
- Oncology and Hematology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy.
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8
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Iwanaga J, Wilson C, Lachkar S, Tomaszewski KA, Walocha JA, Tubbs RS. Clinical anatomy of the maxillary sinus: application to sinus floor augmentation. Anat Cell Biol 2019; 52:17-24. [PMID: 30984447 PMCID: PMC6449588 DOI: 10.5115/acb.2019.52.1.17] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/10/2018] [Accepted: 10/21/2018] [Indexed: 12/26/2022] Open
Abstract
The anatomy of the maxillary sinus, especially its vascular anatomy, and its relationships with the teeth and alveolar processes have been well documented. The development of cone-beam computed tomography has resulted in dentists being more familiar with maxillary sinus floor augmentation procedures. This paper aims to revisit the classic anatomy of the maxillary sinus and review the newly published literature in order to help dentists diagnose in more detail and perform safer surgery of the maxillary sinus.
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Affiliation(s)
- Joe Iwanaga
- Seattle Science Foundation, Seattle, WA, USA.,Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan
| | | | | | | | - Jerzy A Walocha
- Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland
| | - R Shane Tubbs
- Seattle Science Foundation, Seattle, WA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies
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9
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Kawaguchi M, Kato H, Tomita H, Mizuta K, Aoki M, Hara A, Matsuo M. Imaging Characteristics of Malignant Sinonasal Tumors. J Clin Med 2017; 6:jcm6120116. [PMID: 29211048 PMCID: PMC5742805 DOI: 10.3390/jcm6120116] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/01/2017] [Accepted: 12/04/2017] [Indexed: 12/13/2022] Open
Abstract
Malignancies of the nasal cavity and paranasal sinuses account for 1% of all malignancies and 3% of malignancies of the upper aerodigestive tract. In the sinonasal tract, nearly half of all malignancies arise in the nasal cavity, whereas most of the remaining malignancies arise in the maxillary or ethmoid sinus. Squamous cell carcinoma is the most common histological subtype of malignant tumors occurring in this area, followed by other epithelial carcinomas, lymphomas, and malignant soft tissue tumors. Although many of these tumors present with nonspecific symptoms, each tumor exhibits characteristic imaging features. Although complex anatomy and various normal variants of the sinonasal tract cause difficulty in identifying the origin and extension of large sinonasal tumors, the invasion of vital structures such as the brain, optic nerves, and internal carotid artery affects patients’ prognosis. Thus, diagnostic imaging plays a key role in predicting the histological subtype and in evaluating a tumor extension into adjacent structures. This article describes the computed tomography and magnetic resonance imaging findings for malignant sinonasal tumors.
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Affiliation(s)
- Masaya Kawaguchi
- Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan.
- Department of Tumor Pathology, Gifu University School of Medicine, Gifu 501-1194, Japan.
| | - Hiroki Kato
- Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Hiroyuki Tomita
- Department of Tumor Pathology, Gifu University School of Medicine, Gifu 501-1194, Japan.
| | - Keisuke Mizuta
- Department of Otolaryngology, Gifu University School of Medicine, Gifu 501-1194, Japan.
| | - Mitsuhiro Aoki
- Department of Otolaryngology, Gifu University School of Medicine, Gifu 501-1194, Japan.
| | - Akira Hara
- Department of Tumor Pathology, Gifu University School of Medicine, Gifu 501-1194, Japan.
| | - Masayuki Matsuo
- Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan.
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10
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MRI of diffuse large B-cell non-Hodgkin's lymphoma of the head and neck: comparison of Waldeyer's ring and sinonasal lymphoma. Eur Arch Otorhinolaryngol 2016; 274:1079-1087. [PMID: 27738821 DOI: 10.1007/s00405-016-4337-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 10/04/2016] [Indexed: 12/25/2022]
Abstract
To document the magnetic resonance imaging (MRI) features of diffuse large B-cell lymphoma (DLBCL) in Waldeyer's ring (WR) and the sinonasal (SN) region, and to identify any differences between lymphatic and extra-lymphatic DLBCLs, and predictors of disease beyond the neck. Primary, nodal, and multifocal sites on head and neck MRI were compared between 31 WR and 15 SN DLBCL, and between 27 patients with disease confined to the head and neck and 16 patients with disease beyond the neck, using logistic regression. Compared to SN, WR DLBCLs had significantly smaller primary tumour volumes (p = 0.009), less deep invasion (p = 0.001), and more nodal disease (p = 0.016). Tumour site (WR vs. SN) was an independent predictor of deep invasion (p = 0.007). Nodal and multifocal diseases were predictors of disease beyond the neck (p = 0.027 and 0.011, respectively). Lymphatic WR DLBCLs were less locally aggressive but had greater propensity to nodal spread than extra-lymphatic SN DLBCLs. Nodal and multifocal diseases predicted disease beyond the neck.
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11
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Ye H, Gong Z, Yang W, Dai Y. Primary non-Hodgkin lymphoma of the sphenoid sinus with visual disturbance: A report of two cases. Oncol Lett 2016; 11:4252-4254. [PMID: 27313774 DOI: 10.3892/ol.2016.4534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 03/08/2016] [Indexed: 12/30/2022] Open
Abstract
Primary non-Hodgkin lymphoma (PNHL) of the sphenoid sinus is a rare neoplasm that poses a diagnostic challenge to clinicians. The proximity of the optical nerve and canal to the sphenoid sinus is accountable for the high incidence of visual disturbance in PNHL of the sphenoid sinus. In particular, patients whose radiologic diagnosis reveals bone destruction in the lateral wall involved with optical-nerve-canals or cavernous sinus present a high risk of rapidly developing unilateral blindness. The present study reports 2 rare cases of PNHL of the sphenoid sinus. Sudden sight loss may follow minimally invasive biopsy. In such cases, the measures that must be taken for the prevention of permanent sight loss are limited in the absence of the final pathologic diagnosis.
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Affiliation(s)
- Huiping Ye
- Department of Otolaryngology, Head and Neck Surgery, The Affiliated Baiyun Hospital of Guizhou Medical University, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China; Department of Pathology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Zhengpeng Gong
- Department of Otolaryngology, Head and Neck Surgery, The Affiliated Baiyun Hospital of Guizhou Medical University, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Wen Yang
- Department of Pathology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P.R. China
| | - Yubing Dai
- Department of Otolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
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12
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Kato H, Kanematsu M, Watanabe H, Kawaguchi S, Mizuta K, Aoki M. Differentiation of extranodal non-Hodgkins lymphoma from squamous cell carcinoma of the maxillary sinus: a multimodality imaging approach. SPRINGERPLUS 2015; 4:228. [PMID: 26120502 PMCID: PMC4478190 DOI: 10.1186/s40064-015-0974-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 04/09/2015] [Indexed: 01/13/2023]
Abstract
This study aimed to assess the efficacy of a multimodality imaging approach for differentiating between primary extranodal non-Hodgkin’s lymphoma (NHL) and squamous cell carcinoma (SCC) of the maxillary sinus. Twelve NHLs and 29 SCCs of the maxillary sinus were included. CT findings, MR signal intensities, apparent diffusion coefficients (ADCs), and maximum standardized uptake values (SUVmax) were correlated with two pathologies. On CT, permeative growth frequency was greater among NHLs than among SCCs (50 % vs. 10 %; p < 0.01), whereas destructive growth frequency was greater among SCCs than among NHLs (83 % vs. 33 %; p < 0.01). On CT, remaining sinus wall within the tumor was more frequent with NHLs than with SCCs (92 % vs. 34 %; p < 0.01), whereas intratumoral necrosis was more frequent with SCCs than with NHLs (86 % vs. 17 %; p < 0.01). ADCs were lower for NHLs than for SCCs (0.61 vs. 0.95 × 10–3 mm2/s; p < 0.01). No significant differences in MR signal intensities and SUVmax were observed. Tumor growth pattern, remaining sinus wall within the tumor, and intratumoral necrosis were useful CT findings for differentiating between NHLs and SCCs. ADC measurements could assist the differentiation of NHL from SCC.
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Affiliation(s)
- Hiroki Kato
- Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194 Japan
| | - Masayuki Kanematsu
- Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194 Japan ; High-level Imaging Diagnosis Center, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194 Japan
| | - Haruo Watanabe
- Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, 501-1194 Japan
| | | | - Keisuke Mizuta
- Department of Otolaryngology, Gifu University School of Medicine, Gifu, Japan
| | - Mitsuhiro Aoki
- Department of Otolaryngology, Gifu University School of Medicine, Gifu, Japan
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13
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Sandner A, Surov A, Bach AG, Kösling S. Primary extranodal Non-Hodgkin lymphoma of the orbital and paranasal region-a retrospective study. Eur J Radiol 2012; 82:302-8. [PMID: 23092540 DOI: 10.1016/j.ejrad.2012.03.036] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 03/11/2012] [Accepted: 03/12/2012] [Indexed: 11/16/2022]
Abstract
PURPOSE Primary extranodal lymphomas of the orbit and sinonasal region are rare and occur almost only as Non-Hodgkin lymphoma (NHL). The purpose of this study was to determine the frequency of different subtypes of NHL in these regions and to describe their radiological features. MATERIALS AND METHODS Between January 2005 and January 2010, 567 patients with malignant immunoproliferative diseases (MID) were treated at our institution. Primary sinonasal and orbital manifestation was diagnosed in 36 cases. There were 13 women and 23 men with a median age of 67 years. CT and MRI were performed in 14 and 24 patients, respectively. Imaging was re-interpretated and histological subtypes were listed. RESULTS Among all MID primary sinonasal and orbital NHL occurred with a frequency of 6%. Diffuse large cell lymphoma was identified in 11 cases (30%), marginal cell lymphoma in 6 (16%), and extranodal plasmacytoma in 5 (14%). Other subtypes were rare. On CT, lesions of soft tissue attenuation with homogeneous moderate contrast enhancement were seen in all cases. On T2-weighted fat saturated images 52% of the lesions were slightly hyperintense in comparison to unaffected musculature, 41% were isointense, and 7% slightly hypointense. On T1-weighted sequences most lesions (81%) were homogeneously isointense. After contrast administration marked enhancement was seen in 41%, moderate in 52%, and slight enhancement in 7%. CONCLUSION The identified radiological features should be included in the differential analysis of lesions in the orbital and sinonasal regions, but they are not specific enough. For exact therapeutic planning histopathological diagnosis of the subtype is required.
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Affiliation(s)
- Annett Sandner
- Department of Otorhinolaryngology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06097 Halle, Germany.
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14
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Yoon YH, Park WY, Choi YJ, Cho KS. Synchronous, primary, diffuse, large B-cell lymphomas involving the ethmoid sinus and epiglottis: a rare clinical entity. Laryngoscope 2012; 123:702-4. [PMID: 22996757 DOI: 10.1002/lary.23732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 08/22/2012] [Accepted: 08/22/2012] [Indexed: 11/11/2022]
Abstract
Non-Hodgkin's lymphoma (NHL) affecting the ethmoid sinus and epiglottis is uncommon. Furthermore, synchronous NHLs involving the ethmoid sinus and epiglottis are extremely rare and have not been reported previously. This article reports synchronous, primary, diffuse, large B-cell lymphoma (DLBCL) arising in the ethmoid sinus and epiglottis, which was successfully treated by immunochemotherapy. A careful examination of the head and neck is necessary to determine the existence of multiple synchronous primary tumors, because primary synchronous occurrence of DLBCL in the head and neck is unusual and can impact the prognosis adversely.
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Affiliation(s)
- Young-Ho Yoon
- Department of Otorhinolaryngology and Biomedical Research Institute, Busan, South Korea
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15
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Matsuzaki H, Hara M, Yanagi Y, Asaumi JI, Katase N, Unetsubo T, Hisatomi M, Konouchi H, Takenobu T, Nagatsuka H. Magnetic resonance imaging (MRI) and dynamic MRI evaluation of extranodal non-Hodgkin lymphoma in oral and maxillofacial regions. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:126-33. [PMID: 22669071 DOI: 10.1016/j.tripleo.2011.07.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Revised: 07/19/2011] [Accepted: 07/29/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the diagnostic value of magnetic resonance imaging (MRI), especially dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), in extranodal non-Hodgkin lymphoma (NHL) of oral and maxillofacial regions. STUDY DESIGN Thirteen cases with extranodal NHL were examined using MRI. T1-weighted images (T1WI) and T2-weighted images (T2WI) or short TI inversion recovery (STIR) images were obtained in all cases. Contrast-enhanced images and DCE-MRI were acquired in 10 and 7 cases, respectively. On DCE-MRIs, we analyzed the parameters as follows: contrast index at maximal contrast enhancement (CImax), maximum contrast index (CI) gain/CImax ratio, and washout ratios (WR(300), WR(600), and WR(900)) at 300, 600, and 900 seconds after contrast medium injection. RESULTS The signal intensity of all lesions was hypointense to isointense on T1WIs and showed variable contrast enhancement patterns. On T2WIs and STIR images, the signal intensity was isointense to hyperintense in almost all cases. Analysis of DCE-MRI parameters in extranodal NHLs resulted in the identification of 4 types of CI curves according to CImax and WR: (1) CImax greater than 2.0 and WR(900) greater than 40%, (2) CImax greater than 2.0 and WR(900) less than 40%, (3) CImax less than 1.5 and WR(900) greater than 40%, and (4) CImax less than 1.5 and WR(900) greater than 40%. CONCLUSIONS The signal intensities on MRI were not specific to extranodal NHL and resembled those of other tumor types. When CImax was less than 1.5 or WR900 was less than 40%, these parameters contributed to diagnosis in extranodal NHLs.
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Affiliation(s)
- Hidenobu Matsuzaki
- Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University, Okayama, Japan
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Matsuzaki H, Katase N, Hara M, Asaumi JI, Yanagi Y, Unetsubo T, Hisatomi M, Konouchi H, Takenobu T, Nagatsuka H. Primary extranodal lymphoma of the maxilla: a case report with imaging features and dynamic data analysis of magnetic resonance imaging. ACTA ACUST UNITED AC 2011; 112:e59-69. [DOI: 10.1016/j.tripleo.2011.02.052] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Revised: 02/24/2011] [Accepted: 02/28/2011] [Indexed: 11/28/2022]
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17
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Image findings of B cell lymphoma of the palate. Oral Radiol 2011. [DOI: 10.1007/s11282-011-0060-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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18
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Abstract
Clinical assessment of olfactory dysfunction can be challenging. Because olfactory disturbances comprise most chemosensory abnormalities with imaging findings, this article focuses on the imaging of smell disorders. This article reviews the normal imaging appearance of the olfactory apparatus, discusses the respective roles of CT and MRI, provides illustrative imaging of typical pathologic lesions, and discusses a clinically based imaging strategy.
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Affiliation(s)
- Bronwyn E Hamilton
- Department of Radiology and Otolaryngology, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, OR 97239, USA
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19
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Shohat I, Berkowicz M, Dori S, Horowitz Z, Wolf M, Taicher S, Talmi YP. Primary non-Hodgkin's lymphoma of the sinonasal tract. ACTA ACUST UNITED AC 2004; 97:328-31. [PMID: 15024355 DOI: 10.1016/j.tripleo.2003.10.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES We sought to review the records of patients seen at the Chaim Sheba Medical Center (Tel Hashomer, Israel) during a 10-year period with respect to the presenting features, management, and outcome of extranodal non-Hodgkin's lymphoma (NHL) of the sinonasal region. STUDY DESIGN Eight patients were diagnosed with NHL of the paranasal sinuses from 1993 to 2003. The data were reviewed, and we noted the patient's age, sex, the presenting signs and symptoms, staging, histology, treatment, and outcome of NHL. RESULTS The mean age was 61.75 years (range, 24-83 years), with a 1:1 male-to-female ratio. All cases involved the paranasal sinuses, and the most common symptom was nasal obstruction (6 patients). All the patients had large B-cell lymphoma, and all were treated with combined chemotherapy and radiation. Three patients died from the disease, 3 were free of disease after 12 to 36 months of follow-up, and 1 had a recurrence after 60 months. CONCLUSIONS NHLs of the paranasal sinuses are uncommon. Early diagnosis and combined treatment are essential for achieving an optimal outcome.
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Affiliation(s)
- Izhar Shohat
- Department of Oral and Maxillofacial Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel.
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Zhang J, Wang R, Li Y, Zhang F. Extranodal imaging manifestations of non-Hodgkin's lymphoma. Curr Med Sci 2003; 23:324-7. [PMID: 14526448 DOI: 10.1007/bf02829528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2003] [Indexed: 10/19/2022]
Abstract
A series of imaging features of extranodal, multi-systemic involvements in Non-Hodgkin's lymphoma (NHL) were investigated. The clinical data and imaging findings of 16 patients with pathologically proved NHL were retrospectively analyzed. The related literatures were reviewed. Of the 16 cases of NHL, skeletal involvement was found in 4, nasal cavity and nasal sinuses were involved in 4, too. Lesion in the thorax was seen in 3 patients, hepatic involvement occurred in one case, cerebral ventricle was affected in 3 cases, mesentery was involved in one case. Even though extranodal involvement of NHL exhibited extremely variable patterns, there were some relatively typical imaging findings. Emphasized in this report were the relatively specific imaging manifestations of different systems, which may mimic infectious or other neoplasms of different sites. The importance of imaging studies lies in the availability for diagnosis, staging and follow-up of NHL. Combined with the clinical and other related information, the diagnostic accuracy can be further improved, thus, providing reliable evidence in guiding clinical management.
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Affiliation(s)
- Jingfeng Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030
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