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Case Reports
. 2019 Mar 30:20:412-418.
doi: 10.12659/AJCR.913856.

Angiocentric Centrofacial Lymphoma as a Challenging Diagnosis in an Elderly Man

Gabriela Vázquez-Armenta  1 , María Fernanda Gómez-Garnica  1 , Martha Ivón Mondragón-Cervantes  1 , Luis Renee González-Lucano  1
Affiliations
Case Reports

Angiocentric Centrofacial Lymphoma as a Challenging Diagnosis in an Elderly Man

Gabriela Vázquez-Armenta et al. Am J Case Rep. .

Abstract

BACKGROUND Angiocentric centrofacial lymphomas, now known as nasal-type extranodal natural killer T-cell lymphomas, are neoplasms of highly destructive characteristics that mainly affect the nasal cavity and palate. The most frequent clinical presentation includes fever, weight loss, nasal obstruction, epistaxis, nasal or facial edema, as well as necrotic ulcers in the nasal cavity, gums, and palate. It has been found to have an important association with the Epstein-Barr virus. Diagnostic pathology could be difficult due to the typical widespread tissue necrosis. CASE REPORT A 72-year-old Caucasian male sought medical attention with a chief complaint of nasal obstruction for the past 3 years, which only responded partially to unspecific treatment. He also presented with intermittent fever and nocturnal hyperhidrosis. Physical examination with rhinoscopy demonstrated a deviated septum, congestive turbines, and fragile and pale mucous membrane with yellowish, thick mucus. The pathology report described an angiocentric centrofacial lymphoma and a positive serology for Epstein-Barr virus. CONCLUSIONS The objective of this case report was to show that this illness represents a diagnostic challenge for the treating physician. It may be concluded that despite the poor prognosis of the disease, this particular case showed slower evolution and the patient remained stable despite multiple consecutive complications.

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Conflict of interest statement

Conflict of interest: None declared

Conflicts of interest

None.

Figures

Figure 1.
Figure 1.
Axial computed tomography (CT) scan before diagnosis. Complete obstruction of right nasal duct and partial obstruction of bilateral paranasal sinus and left nasal duct.
Figure 2.
Figure 2.
Axial computed tomography (CT) scan during hospitalization. Complete obstruction of right nasal duct and bilateral paranasal sinus, and periorbital edema of right eye.
Figure 3.
Figure 3.
Coronal computed tomography (CT) scan during hospitalization. Complete obstruction of right nasal duct and bilateral paranasal sinus.
Figure 4.
Figure 4.
Patient with a periorbital abscess before hospitalization and treatment.
Figure 5.
Figure 5.
Patient during hospitalization and treatment for the abscess.
Figure 6.
Figure 6.
Patient after treatment for the abscess.
See this image and copyright information in PMC

References

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