J Rhinol.  2024 Jul;31(2):93-100. 10.18787/jr.2024.00017.

Comparative Analysis of the Clinical Manifestations of Sinonasal Natural Killer T-Cell Lymphoma and Diffuse Large B-Cell Lymphoma

• Shin CH
• Aloraimi M
• Kim TG
• Yu MS

• KMID: 2558235
• DOI: http://doi.org/10.18787/jr.2024.00017

Abstract

Background and Objectives
Natural killer T-cell lymphoma (NKTCL) and diffuse large B-cell lymphoma (DLBCL) are the two most prevalent subtypes of lymphoma in the sinonasal region. Accurately differentiating between sinonasal DLBCL and NKTCL is crucial for determining the appropriate treatment and prognosis. The present study compared the clinical characteristics of these two conditions.
Methods
We conducted a retrospective review of 173 patients diagnosed with sinonasal lymphoma at a single institute between 2004 and 2017. This review included only patients with DLBCL and NKTCL who had more than 6 months of follow-up records. We analyzed patient data encompassing clinical characteristics, pathologic findings, radiologic findings, treatment modalities, recurrence, and survival.
Results
Among the patients analyzed, 117 patients were diagnosed with NKTCL and 45 with DLBCL. Endoscopic evaluation revealed a significantly higher incidence of crusting (p<0.001) and necrotic lesions (p=0.001) in patients with NKTCL, whereas polypoid masses were more commonly observed in patients with DLBCL (p<0.001). Computed tomography (CT) scans indicated no significant differences in bilaterality or bone destruction between the two groups. The DLBCL group exhibited a higher rate of concurrent lymph node or organ involvement than the NKTCL group (p<0.001). The 5-year overall survival rate was 67.4% for DLBCL and 69.1% for NKTCL, with no significant difference between the two.
Conclusion
Clinical differences exist between sinonasal DLBCL and NKTCL in terms of endoscopic and CT findings. These distinct characteristics can aid in distinguishing between the two types of sinonasal lymphoma during clinical diagnosis.

Keyword

Sinonasal malignancy; Lymphoma; NK T-cell lymphoma; Diffuse large B-cell lymphoma

Figure

• 

  Fig. 1. Endoscopic findings of DLBCL and NKTCL patients. A: DLBCL tends to present with a polypoidal mass. B: NKTCL tends to present with crusting and necrotic tissue. DLBCL, diffuse large B-cell lymphoma; NKTCL, natural killer T-cell lymphoma.

• 

  Fig. 2. Five-year overall survival (OS) and recurrence-free survival (RFS) rates of DLBCL and NKTCL patients. A: The 5-year OS of DLBCL was 67.4%, and that of NKTCL was 69.1%. The difference was not statistically significant (p=0.647). B: The 5-year RFS of DLBCL was 62.8%, and that of NKTCL was 55.7%. The difference was not statistically significant (p=0.953). DLBCL, diffuse large B-cell lymphoma; NKTCL, natural killer T-cell lymphoma.

Reference

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