MRI appearances of stage IE/IIE extranodal NK/T-cell lymphoma, nasal type, in the upper aerodigestive tract

The clinical symptoms of NK/T-cell lymphoma at presentation are nonspecific and may mimic those of other benign nasal diseases such as rhinitis and nasal polypus. However, radiologic studies regarding this aggressive clinical course entity are limited.

To review 123 newly diagnosed MRI appearances in patients with extra-nodal NK/T-cell lymphoma, nasal type, in a large cohort and determine the characteristic imaging findings.

We investigated the magnetic resonance imaging (MRI) findings of patients with newly diagnosed stage IE/IIE extranodal NK/T-cell lymphoma, nasal type, in the upper aerodigestive tract.

Most nasal cavity patients (63.4%) showed extra nasal cavity involvements. The polypoid pattern was most frequently seen (55.3%), followed by the infiltrative (27.6%) and combined (17.1%) patterns. The polypoid pattern tended to develop in the nasal cavity group, while the infiltration pattern was more common in the non-nasal cavity group (63.4% vs. 60.0%, p < 0.001). Homogeneous iso-intensity was seen in 97.6%, 88.6% and 56.1% of cases on T1-, T2-weighted images and post-contrast images, respectively. Bone destruction and necrosis were observed in 44.7% and 56.3% of patients. Both tumour necrosis and bone destruction were related to tumour size (p = 0.008, 0.001). Only 12.2% of patients had cervical lymphadenopathy Multi-region involvement, irregular growth pattern, predisposition to necrosis and bone destruction, and little lymphadenopathy are valuable for diagnosis and can be used to differentiate these tumours from other malignant tumours.

Our large cohort study of MRI of NK/T cell lymphoma, nasal type, revealed the features of this lymphoma on MRI including some radiologic signs never reported earlier; these findings are invaluable for early diagnosis and may aid future studies aiming to predict the prognosis and response to therapy.