Delayed diagnosis of a destructive natural killer/t-cell Lymphoma of the midface with simultaneously occurring chronic sinusitis with polyps in an 20 year old male african refugee

We present a case of an african refugee, who was presented in our outpatient department with nasal obstruction after massive nasal injury in a refugee accomodation at Lampedusa/Italy. Because oft he breathing disorder dued to loss of cartilaginous infrastructure und nasal polyps a septorhinoplasty and endoscopic sinus surgery was performed. Histologic findings showed a allergic mucinous polypous inflammation. Allery tests revealed sensitizations against tree pollen. In addition a massive increase of total IgE and eosinophilia in the differential leucocyte count was detected. As a causal factor the tropical institute found a infection with Strongyloides stercoralis witch immediately was treated in this facility. The correct diagnosis of a destructive natural killer/t-cell Lymphoma was found after the third operation nearly one year after the first operation. Subsequently a kombined radio-/chemotherapie with a total dose of 40 Gy an 3 cycles of VIPD was carried out. About one year later a recurrence of the lymphoma was treated with a re-chemotherapy after SMILE-protocol. Since then the Patient is in an relapse free status.

Publication History

Publication Date:
18 April 2018 (online)