鼻腔淋巴瘤1例和文献分析

A Case of Nasal Lymphoma and Literature Analysis

摘要:

目标：提高对鼻腔淋巴瘤的认识及其确诊率，总结鼻腔淋巴瘤发病机制、病因、临床表现、诊断、治疗及相关研究进展。方法：回顾性分析一例中年男性鼻腔淋巴瘤患者资料，同时进行相关病例以及文献分析。结果：该患者以“间断鼻塞1月余”之主诉入院，副鼻窦CT显示1) 右侧上窦及鼻腔内软组织密度，和上颌内侧壁骨质吸收：考虑为鼻息肉，请结合镜检。2) 左侧下鼻甲肥大，鼻道阻塞。诊断：1) 鼻腔肿物待诊2) 慢性–鼻鼻窦炎3) 慢性乙型肝炎。患者拒绝术前鼻腔肿物活检以明确肿物性质，并签署拒绝治疗同意书。择期行经鼻内镜下行鼻腔肿物切除术 + ESS术，术后常规肿物病检免疫组化结果考虑为NK/T细胞淋巴瘤。结论：鼻腔肿物应尽早完善相关影像学检查与肿物活检，早期明确诊断，若明确鼻腔淋巴瘤，应结合相关放化疗方式进行治疗。

Abstract: Aim: To summarize the pathogenesis, etiology, clinical manifestations, diagnosis, treatment and related research progress of nasal lymphoma, and to improve their awareness and diagnosis rate. Methods: Retrospective analysis of a patient with mid-life nasal lymphoma in men, as well as, related cases and literature analysis. Results: The patient was admitted to the hospital with “intermittent nasal congestion more than 1 month”, the secondary sinus CT show 1) The density of soft tissue in the upper sinus and nasal cavity on the right side, and the upper jaw inner wall bone absorption: considered as nasal polyps; please combine with the mirror examination. 2) The left lower nasal armor is large and the nasal passage is blocked. Diagnostics: 1) Nasal swelling swollen to be diagnosed 2) Chronic rhinosinusitis 3) Chronic hepatitis B. The patient refused preoperative nasal cavity swollen biopsy to clear the nature of the swelling, and refused to sign the consent form of refusal to treat. The elective period was through the nasal endoscopic downward nasal cavity tumor excision and ESS surgery, and the results of the general swelling disease detection immunohistochemistry were considered NK/T cell lymphoma. Conclusion: The nasal swelling should improve the relevant imaging examination and swelling biopsy as early as possible, and it should be diagnosed early and clearly, and if it is clear lymphoma in the nasal cavity, it should be treated in combination with the relevant chemotherapy method.