Nasal extranodal natural killer T cell lymphoma: an atypical presentation

Abstract

Objective: We report two cases of nasal natural killer T cell lymphoma which presented atypically following surgical intervention.

Case report: Two patients with a previous history of endoscopic nasal surgery presented with progressive facial swelling and necrosis. The histology of several nasal biopsies was suggestive of acute, necrotising inflammation. Considering these patients' midline destruction of the nose and face, and their inconclusive biopsies, immunohistochemical studies were undertaken, enabling the diagnosis of peripheral natural killer T cell lymphoma.

Conclusion: Natural killer T cell lymphoma of the sinonasal tract is an important differential diagnosis of destructive lesions of the nose and midface. The definitive diagnosis is often delayed. Hence, this tumour should be considered in patients with atypical presentations of acute inflammation following surgical intervention; such patients should be thoroughly investigated. Early immunohistochemical investigation is needed to enable prompt diagnosis in suspicious cases.