Korean J Otorhinolaryngol-Head Neck Surg.  2024 Sep;67(9):482-487. 10.3342/kjorl-hns.2023.01025.

Clinical Analysis of Sinonasal Malignant Lymphoma: Treatment Modalities and Prognostic Factors

• Kim SY
• Kim JK
• Kim YC
• Yoon J
• Kim SM
• Park J
• Song DH
• Kim HJ

• KMID: 2559346
• DOI: http://doi.org/10.3342/kjorl-hns.2023.01025

Abstract

Background and Objectives
Sinonasal malignant lymphoma is rare and aggressive. Its low incidence has made detailed studies on epidemiology, survival, and consensus treatment modalities a challenge, and also has limited developing standardized protocols for diagnosis and management. This study analyzes the clinical factors of patients diagnosed with sinonasal malignant lymphoma and their treatment modalities to understand therapeutic outcome and prognostic factors.
Subjects and Method
The medical records of patients diagnosed between 2011 and 2020 as sinonasal (SN) malignant lymphoma (extranodal NK/T cell lymphoma [ENKTL]/diffuse large B cell lymphoma [DLBCL]) in Seoul national university hospital were retrospectively reviewed.
Results
A total 42 patients were included in the study. Of those, 30 patients were SN-ENKTL, 12 patients were SN-DLBCL. The mean age of SN-DLBCL and SN-DLBCL groups was 52.8±14.4, 60.8±12.4, respectively. The main chief complaint was nasal obstruction (54%). Approximately 75% were diagnosed as stage II (Ann-Arbor staging system) and most of the patients received multi-agent chemotherapy or chemoradiotherapy. The 3-year overall survival rate for SN-DLBCL and SN-DLBCL groups was roughly 90%, 88.9%, respectively and the average of disease-free survival period was approximately 41.1 and 22.1 months, respectively, after initiation of treatment.
Conclusion
We found that sinonasal malignant lymphoma is highly responsive to chemo or chemoradiotherapy. Early accurate diagnosis is important as early-stage patients receiving therapy may benefit from chemo or chemoradiotherapy. Our clinical data showed that in ambiguous situations, wide excision should be considered for diagnosis.

Keyword

Diffuse large B cell lymphoma; Lymphoma, extranodal NK-T-cell; Sinonasal tract