Int Arch Otorhinolaryngol 2014; 18 - a2135
DOI: 10.1055/s-0034-1388904

B-Cell Lymphoma Nasal Findings with Intermediate between Diffuse Large B-Cell and Burkitt—A Case Report

Luis Alan Cardoso de Melo 1, Carla Graciliano Arguello Nunes 1, Iury Lima Veloso 1, José Vicente Tagliarini 1, Thaís Gomes Abrahão Elias 1, Thereza Lemos de Oliveira Queiroga 1
  • 1Universidade Estadual Paulista (Unesp)

Introduction: Lymphoma is the second most common malignancy of head and neck. Sinonasal involvement occurs mainly by Asian countries in T-lineage and by west countries in B-lineage, being the most common subtype diffuse large B-cell lymphoma.

Objective: This study aims to report a case of sinonasal lymphoma B cells with immunohistochemical/immunophenotype findings between diffuse large B-cell lymphoma and Burkitt lymphoma.

Resumed Report: An 87-year-old man presented with a history of more than 3 months of nasal obstruction, purulent rhinorrhea earlier, and growth nodulation topography in maxillary and right periorbital edema.

Physical Examination: A reddish mass obstructing left middle meatus and bulging of the ipsilateral maxillary and periorbital edema.

Biopsy of the Lesion: There was an unclassifiable lymphoma B cells with intermediate findings between diffuse large B-cell lymphoma and Burkitt lymphoma, diffuse expression of CD20, and positive for BCL-6 and CD10. Computed tomography and magnetic resonance showed mass in the soft tissues of the face to the right region with invasion of the orbit and maxillary sinus cavity right nasal. The patient was subjected to radiotherapy and chemotherapy with significant therapeutic response.

Conclusion: Extranodal involvement is more common in diffuse lymphoma subtype of large B cells, reaching 40% of cases, gastrointestinal tract, skin, bone marrow, and oral mucosa the most frequent sites. Sinonasal involvement is less prevalent (range, 9-13%), especially the maxillary sinus and ethmoid. Signs and symptoms are purulent rhinorrhea, nasal obstruction, headache, pain in hemiface, epistaxis, diplopia, blurred vision, and facial edema.