[Highly malignant T-cell non-Hodgkin lymphoma (nasal type) of the hard palate]

The monomorphic clinical aspect of destructive mid-face lesions is characterised by inflammation, induration and granulomatous transformation. This feature can be caused by various infections, toxical noxa, Wegener's Granulomatosis and different neoplasms. The case of a 19 year old patient with EBV associated nasal type T-cell lymphoma located at the hard palate is presented. The diagnostic approach and difficulties in diagnosing this entity assessing by using multiple biopsies, serological and molecularbiological detection of EBV association and immunohistochemistry for atypic T-cells are elucidated. In the presented case the treatment with chemotherapy and irradiation following a well-defined therapy concept leaded to a three year recurrence-free survival so far. The comparison of the key-histological findings and the major differential diagnoses is mandatory to establish the final diagnosis of lymphoma. This is the basement for treating this disease with combined chemotherapy and irradiation for optimizing survival.