Extranodal natural killer/T-cell lymphoma presenting as orbital cellulitis

Area of Science:

• Oncology
• Ophthalmology
• Otorhinolaryngology

Background:

• Extranodal natural killer/T-cell lymphoma (NKTCL) is a rare and aggressive hematologic malignancy.
• NKTCL often presents with non-specific symptoms, making early diagnosis challenging.

Observation:

• A 56-year-old male presented with acute orbital cellulitis and pansinusitis symptoms.
• Initial presentation included decreased visual acuity, proptosis, periorbital edema, and restricted extraocular movements.
• Despite conservative treatment, the patient showed no clinical improvement.

Findings:

• Biopsy of the ethmoidal sinus revealed extranodal NKTCL.
• Imaging confirmed orbital involvement, intracranial extension into the cavernous sinus, and meningeal involvement.
• The patient succumbed to the illness two months after diagnosis despite chemotherapy.

Implications:

• This case underscores NKTCL's potential to mimic common orbital and sinus conditions.
• Highlights the need for high clinical suspicion and prompt diagnostic workup for aggressive NKTCL.
• Emphasizes the poor prognosis associated with advanced-stage extranodal NKTCL.