Non-Hodgkin's lymphomas of the sinonasal region: histologic subtypes and their clinicopathologic features

The authors describe 11 patients with non-Hodgkin's lymphoma arising in the nasal cavity or paranasal sinuses. Seven were men and four were women. The median age of the women was 76 years; the median age of the men was 45 years. The most common presenting symptoms were nasal obstruction and unilateral facial swelling. The most frequent sites of disease were maxillary antrum (ten cases), nasal cavity (eight cases), and ethmoid sinus (seven cases). Eight patients had involvement of multiple sinuses. Six patients were clinical stage I E, two were II E, one was stage III E, and two were stage IV. Histologic subtypes included diffuse small cleaved cell (1 case), diffuse large cell (4 cases), and diffuse large cell immunoblastic (6 cases). Three patients having immunoblastic lymphoma had longstanding sinusitis, rhinitis, and allergies. Overall, 55% of patients died of disease. Three of four patients with the diffuse large cell subtype were free of tumor (mean follow-up 50 months). Five of six patients having immunoblastic lymphoma died of disease from 1 to 13 months following diagnosis (mean 6.4 months).