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Extranodal NK-T cell lymphomas as a rare disease with the prognostic necessity of an early diagnosis
Introduction Nasal NK-T cell lymphomas are defined as non-Hodgkin's lymphomas, of which 75 % are located in the upper aerodigestive tract and are frequently associated with the EBV virus. The prognosis strongly depends on an early diagnosis. The therapeutic procedure includes chemotherapy in combination with radiotherapy.
Patient and method We present a case of a 24-year-old patient with the suspected diagnosis of acute pharyngolaryngitis with inability to eat and fever. In addition, we saw a slightly bleeding mucosa of the left inferior turbinate after functional endonasal endoscopic paranasal sinus surgery alio loco a few months before. The immediate initiated antibiotic treatment did not lead to an improvement of the findings. Further diagnostics were initiated.
Result An interdisciplinary search for causes was initiated together with colleagues from rheumatology, oncology and pathology. Histopathological findings after panendoscopy first indicated orofacial granulomatous dermatosis. After further immunohistochemical processing, however, the diagnosis of NK-T cell lymphoma could finally be made.
Conclusion Supposedly banal cases of bacterial infections of the upper aerodigestive tract should be promptly followed by a targeted search for further causes if there was no response to antibiotic therapy. A histological confirmation of findings by panendoscopy is potentially decisive for the prognosis of the patients.
10 June 2020 (online)
© Georg Thieme Verlag KG
Stuttgart · New York