Extranodal (Nasal Variant) NK/T -Cell Lymphoma of Head and Neck: Our Experience From a Tertiary Care Centre

Extranodal nasal variant NK/T-cell lymphomas (ENNK) are rare, particularly in the Indian population, with limited published cohorts. This study evaluates the clinical presentation and immunohistochemical (IHC) marker profile of ENNK in Northeast India.

A retrospective review was conducted on biopsy-proven ENNK cases from January 2014 to December 2024. Age and gender distribution of the study population, different sites involved by the ENNK, symptoms' duration & presentation, IHC analysis, staging of ENNK, treatment regimen with complications, survivability analysis across different stages, and overall survival analysis were done. Descriptive statistics, chi-square analysis, and the Kaplan-Meier method for survival analysis were performed.

Thirty-four ENNK patients were identified (median age 45; range 8-80 years; 76% male). The nose and paranasal region were affected in 76%. All cases showed Cluster of Differentiation (CD) 3 and CD 56 positivity, and Epstein-Barr virus positivity. Staging at diagnosis was: I (15%), II (73%), III (3%), and IV (9%). 59% of patients had follow-up data, with a mean survival of 24.6 ± 14.2 months (range 7-57). No statistically significant survival difference was observed across stages. Kaplan-Meier analysis demonstrated that the modified SMILE regimen (dexamethasone, methotrexate, ifosfamide, pegylated L-asparaginase, and etoposide) provided superior cumulative survival in our study.

This is the first detailed ENNK cohort from Northeast India; patients referred to our center as refractory chronic sinusitis or granulomatous disease turned out to be ENNK. Practicing otorhinolaryngologists in Asia should include ENNK in differential diagnoses for early detection and improved outcomes.