Natural killer cell T-cell lymphoma (nasal type), a rare and aggressive type of non-Hodgkin's lymphoma: Case report

In the sinonasal tract, diffuse large B-cell lymphomas are the predominant type non-Hodgkin's lymphoma while natural killer (NK) cell T-cell lymphoma, the nasal type, constitute only 3%-12% of NHLs in this region and is the more aggressive subtype. NK cell T-cell lymphoma mostly occurs in male at the median age of 50 years and has got a poor prognosis with a 3-years overall survival (OS) of 46.3% and a 5-years OS of 42%. We present a case of a 37 year old lady with a mass in nasal cavity extending to the nasopharynx and upper cervical lymphadenopathy. Biopsy from the nasal mass showed features of NHL, NK cell T-cell type although immunohistochemistry was not available for the definite diagnosis. For localized diseases, chemo-radiotherapy forms the mainstay of treatment with complete remission in up to 50% of cases while chemotherapy alone is given to patients with disseminated disease with a very poor outcome (5-year survival of 10%-45% only). In our case, the patient received first dose of chemotherapy and then died at home before receiving the second dose showing the aggressive nature of the disease. Timely diagnosis with typical imaging features and histological diagnosis can improve the outcome with complete cure in almost half of the cases with localized disease.