Nasal T-cell lymphoma: a case presentation

Nasal lymphoma represents 2.2 to 6.8% of extranodal lymphomas and presents a difficult diagnosis due to the variability of cell populations. Lesions may evolve de novo or may develop as a spectrum of midline lethal granuloma (MLG). The majority of extranodal disease is felt to be of B-cell origin, but there is evidence that those associated with MLG are of T-cell origin. We present a case of a 41-year-old Jamaican female with recurrent lesions of the nasal tip and vestibule beginning at age 16. Intensive investigation and review of the pathology continued to show nonspecific granuloma. However, at age 34, the lesion was diagnosed as T-cell lymphoma (HTLV-I related), and a later review of the slides suggests this may have been present as early as 8 years before diagnosis. She received 4000 cGy to the nose and nasopharynx over 25 treatments. Although the question of two small axillary nodes exists, the primary site has been disease free for 7 years.