types of lymphoma |T lymphomas of nasal cavities and sinusExtra-nodal t lymphomas of the nasal cavitises and sinuses

T lymphomas of nasal cavities and sinusExtra-nodal t lymphomas of the nasal cavitises and sinuses

Summary
Introduction
T-lymphomas of nasal cavities and sinuses are rare, often posing a differential diagnosis problem with other destructive and nécrosants processes of the Nasosinusien tract.

Materials and methods
It is a retrospective study of 11 observations of lymphomas T of nasal cavities and sinuses, collected in the ENT department of F. Axed hospital in Sousse, Tunisia, this over a period of ten years (1995 – 2004).

Results
Patients were on average aged 41 years. The seat of choice was the nasal pits. The symptomatology was non-specific. The ANATOMOPATHOLOGIC study concluded with T/NK lymphoma in two patients and peripheral T lymphoma with no other indication (SAI) in nine patients. The search for Epstein Barr virus in tumour cells, using immunohistochemistry and in situ hybridization, in seven patients, had returned positive. The extension balance, carried out in ten patients, found metastases at a distance in three cases. The treatment, introduced in nine patients, consisted of: an exclusive radiotherapy (a patient), a radiochemotherapy association (three patients) and a single polychemotherapy (five patients). Two patients could not benefit from treatment due to a rapidly unfavourable evolution. Following an average 11-month follow-up, Evolution was marked by: The occurrence of death in seven patients; A remission in three patients. A patient was lost in sight.

Conclusion
T-lymphomas of nasal cavities and sinuses are rare in Tunisia. The diagnosis is mainly based on the clinic, the immunophénotypiques and molecular characteristics. The morphological aspect of histopathological examination is not very specific. These lymphomas are aggressive and require multidisciplinary support.

Abstract
Introduction
Extra-Nodal T lymphomas of the ear, nose, and throat (ENT) are unusual in Western countries, with differential diagnosis from other destructive and necrotizing lesions of the Sino-nasal tract often difficult.

Material and methods
Eleven cases of extra-nodal lymphomas of the upper aerodigestive tract tract managed in the ENT Department of F. Minced hospital in Sousse, Tunisia, were retrieved over a 10-year period (1995 – 2004). The aim of our study was to report the clinical and pathological data and the outcome for each patient.

Results
The median age of patients was 41-years. The most frequent site of involvement was the nasal cavity. Clinically, the symptoms were not specific. Histological examination identified two cases of T/NK lymphoma and nine cases of T-lymphoma not otherwise specified. Immunohistochemistry and in situ hybridization techniques positively detected Epstein-Barr virus in tumor cells, in seven cases. Tumor staging, in 10 patients, found distant metastasis in three. Nine patients underwent the following treatment: exclusive radiotherapy (one patient), radiochemotherapy (three patients), and exclusive Polychemotherapy (five patients). The two remain patients had no treatment because of a rapidly unfavorable progression. After a median follow-up of 11-months, clinical outcome consists in death in seven patients and remission in three patients; One patient was lost of follow-up.

Conclusion
Extra-Nodal lymphomas of the ENT tract are rare in Tunisia. Clinical presentation is not specific, depending on the lymphoma location. Diagnosis related on clinical presentation and immunophenotypic and molecular characteristics; Morphological features are not specific. These are aggressive lymphomas, often requiring multidisciplinary management.