Extranodal natural killer/T-cell lymphoma nasal type: detection by computed tomography features

Area of Science:

• Radiology
• Oncology
• Otorhinolaryngology

Background:

• Nasal natural killer/T-cell lymphoma (NKTL) presents with infiltrative patterns on CT, mimicking benign inflammatory conditions.
• Accurate differentiation between NKTL and chronic rhinosinusitis (CRS) is crucial for timely and appropriate treatment.

Purpose of the Study:

• To develop a CT-based measurement method for nasal floor and septum thickness.
• To establish critical mucosal thickness values for distinguishing NKTL from benign inflammatory diseases.
• To create a diagnostic flowchart for improved NKTL detection.

Main Methods:

• Retrospective analysis of 32 nasal NKTL patients and 173 CRS patients.
• Standard computed tomography (CT) of paranasal sinuses was performed.
• Nasal floor and septum mucosal thickness were measured on coronal CT sections.

Main Results:

• Patients with NKTL exhibited significantly thicker nasal floors and/or septa compared to CRS patients (P < .001).
• Cutoff values of 2.0 mm for nasal floor and 2.5 mm for nasal septum thickness showed high specificity.
• A thickness exceeding these thresholds suggests a <2% probability of being CRS, warranting consideration of other diagnoses.

Conclusions:

• Nasal floor mucosal thickness >2.0 mm or nasal septum mucosal thickness >2.5 mm are valuable indicators for potential NKTL.
• A diagnostic flowchart incorporating these measurements can aid in the early detection of nasal NKTL.
• These findings facilitate the differentiation of NKTL from common inflammatory sinus conditions.