Abstract
Purpose To describe the clinical, morphologic, and immunohistochemical features of a case of paranasal natural killer/T-cell lymphoma (NKTL) with ocular involvement. Case report In March 2005 the patient presented with a maxillary sinusitis and upper nasal obstruction. In July she underwent a nasal computed tomography (CT) scan and multiple biopsies of the granulomatous tissue in the nasal fossae. The diagnosis was NK/T non-Hodgkin’s lymphoma nasal type, stage IV A. Afterwards she presented anterior uveitis. In September after the diagnosis of lymphoma the patient underwent a bone marrow biopsy and thoracic and abdominal CT scan. An ophthalmic examination including visual acuity assessment and fundoscopic examination was made. In October she started chemotherapy cycles. Maxillary CT scan and ophthalmic examinations were performed during the cycles. In January 2006 after severe recurrences of panuveitis a diagnostic vitrectomy was performed. Results A diagnosis of T-lymphoma cells in the vitreous was made; the tumor was most likely originating from her paranasal NKTL. The condition of the patient deteriorated rapidly and she expired on February 2006. Conclusions Nasal and paranasal sinus lymphomas are rare, but aggressive diseases with a tendency to invade tissues and spread to CNS, including the eye. Ocular manifestations prior to systemic ones may be useful to monitor the response to therapy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Chan JKC, Jaffe ES, Ralfkiaer E (2001) Extranodal NK/T-cell lymphoma, nasal type. In: Jaffe ES, Harris NL, Stein H, Vardiman JW (eds) World Health Organizzation classification of tumours: tumours of haematopoietic and lymphoid tissues. IARC, Lyon, pp 204–207
Harris NL, Jaffe ES, Diebold J et al (1999) World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting, Airlie House, Virginia, November 1997. J Clin Oncol 17:3835–3849
Kwong YL, Chan AC, Liang RH (1997) Natural Killer cell lymphoma/leukaemia: pathology and treatment. Hematol Oncol 15:71–79
Hon C, Kwok AK, Shek TW, Chim JC, Au WY (2002) Vision-threatening complications of nasal T/NK lymphoma. Am J Ophthalmol 134:406–410
Coupland SE, Krause L, Delecluse HJ et al (1998) Lymphoproliferative lesions of the ocular adnexa. Analysis of 12 cases. Ophthalmology 105:1430–1441
Meyer JH, Scharf B, Gerling J (1996) Midline granuloma presenting as orbital cellulites. Graefes Arch Clin Exp Ophthalmol 234:137–139
Jakobiec FA, Lefkowitch J, Knowles DM (1984) II. B- and T-lymphocytes in ocular disease. Ophthalmology 91:635–654
Peterson K, Gordon KB, Heinemann MH, De Angelis LM (1993) The clinical spectrum of ocular lymphoma. Cancer 72: 843–849
Harris NL, Jaffe ES, Stein H et al (1994) A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 84:1361–1392
Chan CC, Wallace DJ (2004) Intraocular lymphoma: update on diagnosis and management. Cancer Control 11:285–295
Clearly KR, Batsakis JG (1994) Sinonasal lymphomas. Ann Otol Rhinol Laryngol 103:911–914
Jaffe ES, Chan JKC, Su U et al (1996) Report of the workshop on nasal and related extranodal angiocentric T/Natural Killer cell lymphomas: definitions, differential diagnosis and epidemiology. Am J Surg Pathol 20:103–111
Macon WR, William ME, Greer JP et al (1996) Natural killer-like T cell lymphoma; aggressive lymphomas of T-large granular lymphocytes. Blood 87:1474–1483
Kitamura A, Yamashita Y, Hasegawa Y, Kojima H, Nagasawa T, Mori N (2005) Primary lymphoma arising in the nasal cavity among Japanese. Histopathology 47:523–532
Laskin JJ, Savage KJ, Voss N, Gascoyne RD,Connors JM (2005) Primary paranasal sinus lymphoma: natural history and improved outcome with central nervous system chemoprophylaxis. Leuk Lymphoma 46:1721–1727
Jacobs C, Hoppe RT (1985) Non-Hodgkin’s lymphomas of head and neck extranodal sites. Int J Radiat Oncol Biol Phys 11(2):357–364
Frierson HF Jr, Mills SE, Innes DJ Jr (1984) Non-Hodgkin’s lymphomas of the sinonasal region: histologic subtypes and their clinicopathologic features. Am J Clin Pathol 81(6):721–727
Tran LM, Mark R, Fu YS, Calcaterra T, Juillard G (1992) Primary non-Hodgkin’s lymphomas of the paranasal sinuses and nasal cavity. A report of 18 cases with stage IE disease. Am J Clin Oncol 15:222–225
Logsdon MD, Ha CS, Kavadi VS, Cabanillas F, Hess MA, Cox JD (1997) Lymphoma of the nasal cavity and paranasal sinuses: improved outcome and altered prognostic factors with combined modality therapy. Cancer 80:477–488
Coupland SE, Joussen A, Anastassiou G, Stein H (2005) Diagnosis of a primary uveal extranodal marginal zone B-cell lymphoma by chorioretinal biopsy: case report. Graefes Arch Clin Exp Ophthalmol 243:189–197
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cimino, L., Chan, CC., Shen, D. et al. Ocular involvement in nasal natural killer T-cell lymphoma. Int Ophthalmol 29, 275–279 (2009). https://doi.org/10.1007/s10792-008-9220-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-008-9220-8