Extranodal natural killer/T-cell lymphoma presenting as cavernous sinus syndrome

Area of Science:

• Oncology
• Neurology
• Pathology

Background:

• Extranodal natural killer (NK)/T-cell lymphomas are rare, aggressive central nervous system (CNS) tumors.
• These lymphomas often affect the nasal cavity and paranasal sinuses, presenting with poor prognosis and challenging detection due to varied clinical and neuroimaging findings.
• Pathological examination is crucial for definitive diagnosis.

Purpose of the Study:

• To report a case of NK/T-cell lymphoma presenting with cavernous sinus syndrome via direct CNS extension from the nose.
• To highlight the diagnostic challenges and aggressive nature of these lymphomas.

Main Methods:

• Case report detailing clinical presentation, neuroimaging, and pathological findings.
• Discussion of fluorodeoxyglucose (FDG)-positron emission tomography combined with computed tomography (FDG-PET/CT) for lymphoma evaluation.
• Review of the literature on NK/T-cell lymphomas and their management.

Main Results:

• The case involved an NK/T-cell lymphoma extending from the nasal cavity to the CNS, causing cavernous sinus syndrome.
• The tumor exhibited characteristics typical of aggressive NK/T-cell lymphomas.
• FDG-PET/CT demonstrated avid uptake, suggesting its utility in evaluating such lymphomas.

Conclusions:

• NK/T-cell lymphomas are aggressive malignancies with poor outcomes and undefined optimal therapies.
• Early detection using methods like FDG-PET/CT may improve the evaluation of these challenging CNS lymphomas.
• Cavernous sinus syndrome can be a presenting manifestation of CNS NK/T-cell lymphoma due to direct extension.