Journal of the Chinese Medical Association
Volume 70, Issue 5 , Pages 207-212, May 2007

Nasal NK/T-cell Lymphoma: Computed Tomography and Magnetic Resonance Imaging Findings

  • Chang-Hsien Ou

      Affiliations

    • Department of Radiology, Buddhist Tzu-Chi General Hospital, Taichung Branch, Taiwan, R.O.C.
    • ,
  • Clayton Chi-Chang Chen

      Affiliations

    • Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • Department of Radiological Technology, Central Taiwan University of Science and Technology, Taichung, Taiwan, R.O.C.
    • Department of Physical Therapy, Hungkuang University, Shalu, Taiwan, R.O.C.
    • Department of Physical Therapy, National Yang-Ming University, aipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Clayton Chi-Chang Chen, Department of Radiology, Taichung Veterans General Hospital, 160, Section 3, Chung-Kang Road, Taichung 407, Taiwan, R.O.C.
    • ,
  • Jin-Ching Ling

      Affiliations

    • Section of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • ,
  • Jyh-Wen Chai

      Affiliations

    • Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • ,
  • Chen-Hao Wu

      Affiliations

    • Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • ,
  • Wen-Hsien Chen

      Affiliations

    • Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • ,
  • Hao-Chun Hung

      Affiliations

    • Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • ,
  • Tain-Lee

      Affiliations

    • Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • School of Medicine, Chung-Shan Medical University, Taichung, Taiwan, R.O.C.
    • ,
  • Tzu-Lung Ho

      Affiliations

    • Department of Radiology, Buddhist Tzu-Chi General Hospital, Taichung Branch, Taiwan, R.O.C.

Received 8 September 2006; accepted 19 April 2007.

Background

Primary nasal natural killer (NK)/T-cell lymphoma is the most common cellular subtype seen in nasal lym-phomas. It is rare in the Western population but occurs more frequently in Asia, South America, and Mexico. The purpose of this study was to describe the computed tomography (CT) and magnetic resonance (MR) imaging findings of primary nasal NK/T-cell lymphoma.

Methods

During the period between January 1990 and June 2006, the CT (n=24) and MR (n = 6) images of 24 patients with biopsy-proved nasal NK/T-cell lymphoma were reviewed retrospectively. Both CT and MR images were evaluated for site and extent of disease and for pattern of involvement of adjacent areas.

Results

The most common symptoms at presentation were nasal obstruction, nasal discharge, and epistaxis. There was involvement of the unilateral nasal cavity in 16, bilateral nasal cavity including nasal septum in 5 and nasal choana in 3. Sites of extension outside the nasal cavity included tumor extension into paranasal sinuses (n = 15), nasopharynx (n = 5), nasal labial fold (n = 3), oropharynx (n=2), infratemporal fossa (n = 2), other subcutaneous soft tissue of the face (n = 2) and anterior cranial fossa base (n = 1). Bony destruction was demonstrated in 18 cases, involving the sinus bony wall (n = 15), nasal turbinate (n = 10), lamina papyracea (n = 6), orbital floor (n = 3), and hard palate (n = 2). Regional lymphadenopathy was also detected in 3 patients with nasal NK/T-cell lymphoma.

Conclusion

The CT and MR appearances of nasal NK/T-cell lymphoma are nonspecific, and the diagnosis requires histologic confirmation. However, the differential diagnosis of nasal NK/T-cell lymphoma should be included if the images present soft tissue of the nasal cavity with bony erosion or destruction; involvement of the orbital cavity, nasopharynx and infratemporal fossa; and subcutaneous or nasolabial fold soft tissue infiltration, especially in Asian populations.

Key Words:  computed tomography , magnetic resonance imaging , nasal cavity , nasal natural killer/T-cell lymphoma

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PII: S1726-4901(09)70359-4

doi:10.1016/S1726-4901(09)70359-4

Journal of the Chinese Medical Association
Volume 70, Issue 5 , Pages 207-212, May 2007

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