PARANASAL SINUS NON-HODGKIN LYMPHOMA - A RARE CASE REPORT

Abstract

To report a rare case of paranasal sinus lymphoma in a young adult. Case
report - A 23 years old male patient, known case of NHL of right maxillary sinus, treated outside with
chemotherapy (CHOP with intrathecal methotrexate) and defaulted for follow up after complete
resolution of symptoms, presented to our department with swelling of the right eye for about 1 month.
Then on clinical examination the patient had chemosis and proptosis of the right eye and swelling of
the right maxillary region. Biopsy from the lesion showed DLBCL. With imaging it was found that the
lesion was localized to right maxillary sinus and adjoining structures and bilateral neck nodes only,
and the case was labelled as relapse of extranodal NHL stage II AE. Since the patient was a known
seropositive case of HBsAg, he was treated with palliative radiotherapy alone. The patient achieved a
very good response clinically. Discussion - Most extranodal NHL occurs in fifth to sixth decade, but in
our case it was in third. In seropositive cases of HBsAg, chemotherapy may be avoided to prevent
reactivation of hepatitis B viral infection. Lymphomas should always be kept in mind as one of the
differential diagnosis when considering the tumors of sinonasal region. Radiotherapy played the main
role in the management of lymphoma in seropositive cases of HBsAg, especially in the relapse or
recurrent setting. The importance of looking for viral markers before starting chemotherapy is once
again stressed.