Factors Contributing to Delay in Diagnosis of Sinonasal Natural Killer/T-Cell Lymphoma

Extranodal natural killer/T (NK/T)-cell lymphoma is an aggressive disease that frequently presents in the sinonasal cavity. NK/T-cell lymphoma is much more common in Asia than the United States. As the disease frequently presents with nasal obstruction and mucosal inflammation, in its early stages NK/T-cell lymphoma may mimic chronic rhinosinusitis and other inflammatory disorders. We present two cases, one of a 30-year-old Mexican woman and one of a 34-year - Vietnamese man, where the diagnosis of NK/T cell lymphoma was initially delayed because the patients were being treated for chronic rhinosinusitis. Both patients were subsequently treated with radiation and have no evidence of recurrence. We discuss the potential factors contributing to the delay in diagnosis in these two cases. Although NK/T-cell lymphoma is rare in the United States, early referral to an otolaryngologist and low threshold for biopsy in suspicious cases may facilitate rapid diagnosis of this and other less common inflammatory and neoplastic diseases involving the nasal cavity and paranasal sinuses.