Clinical analysis of extranodal non-Hodgkin's lymphoma in the sinonasal tract

  • J.-S. Woo
  • J. M. Kim
  • S. H. Lee
  • S. W. Chae
  • S. J. Hwang
  • H.-M. Lee
Head and Neck Oncology


We investigated the clinical analysis of non-Hodgkin's lymphoma (NHL) of the sinonasal tract, including the survival rate and treatment outcome. Fifty patients who had previously received a diagnosis of extranodal NHL of the sinonasal cavity from May 1992 to April 2001 were included. We reviewed the patients' clinical characteristics and the survival rates, retrospectively. Of 50 patients, 49 were classified as having extranodal NK/T cell lymphoma and only one patient as having diffuse large B cell (DLBC) lymphoma according to the new WHO classification. Even though higher mortality rates were observed in patients receiving chemotherapy alone than in those receiving chemotherapy and radiation therapy in the advanced stage, the combination treatment of chemotherapy and radiation therapy failed to demonstrate a significantly higher survival rate.


Clinical analysis Non-Hodgkin's lymphoma Sinonasal tract 



This study was supported by the Brain Korea Project 21 and Korea University.


  1. 1.
    Burton GV, Atwater S, Borowitz MJ, Huang AT (1990) Extranodal head and neck lymphoma. Prognosis and patterns of recurrence. Arch Otolaryngol Head Neck Surg 116: 69–73PubMedGoogle Scholar
  2. 2.
    Chan JK, Banks PM, Cleary ML, Delsol G, De Wolf-Peeters C, Falini B (1994) A proposal for classification of lymphoid neoplasms (by the International Lymphoma Study Group). Histopathology 25: 517–536PubMedGoogle Scholar
  3. 3.
    Chan JKC (2001) The new world health organization classification of lymphomas: the past, the present and the future. Hematol Oncol 19: 129–150CrossRefPubMedGoogle Scholar
  4. 4.
    Chan JK, Ng CS, Lau WH, Lo ST (1987) Most nasal/nasopharyngeal lymphomas are peripheral T-cell neoplasms. Am J Surg Pathol 11: 418–429PubMedGoogle Scholar
  5. 5.
    Cheung MMC, Chan JKC, Lau WH, FooW, Chan PT, Ng CS, Ngan RK (1998) Primary non-Hodgkin's lymphoma of the nose and nasopharynx: clinical features, tumour immunophenotype and treatment outcome in 113 patients. J Clin Oncol 16: 70–77PubMedGoogle Scholar
  6. 6.
    Cleary K, Batsakis J (1994) Sinonasal lymphomas. Ann Otol Rhinol Laryngol 103: 911–914PubMedGoogle Scholar
  7. 7.
    Fellbaum C, Hansmann ML, Lennert K (1989) Malignant lymphomas of the nasal cavity and paranasal sinuses. Virchows Arch Pathol Anat Histopathol 414: 399–405Google Scholar
  8. 8.
    Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP (1993) Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Eng J Med 328: 1002–1006CrossRefGoogle Scholar
  9. 9.
    Glick JH, Kim K, Earl J (1995) An ECOG randomized phase III trial of CHOP vs CHOP plus radiotherapy for intermediate grade early stage non-Hodgkin's lymphoma (Abstr). Proc Am Soc Clin Oncol 14: 391Google Scholar
  10. 10.
    Han JS, Lee ST, Min YH, Ko YW, Yang WI, Kim KW (2002) Therapeutic outcome of Epstein-Barr virus positive T/NK cell lymphoma in the upper aerodigestive tract. Yonsei Med J 43: 175–182PubMedGoogle Scholar
  11. 11.
    Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML (1994) A revised European-American classification of lymphoid neoplasm: a proposal from the International Lymphoma Study Group. Blood 84: 1361–1392PubMedGoogle Scholar
  12. 12.
    Hatta C, Ogasawara H, Okita J, Kubota A, Ishida M, Sakagami M (2001) Non-Hodgkin's malignant lymphoma of the sinonasal tract—treatment outcome for 53 patients according to REAL classification. Auris Nasus Larynx 28: 55–60CrossRefPubMedGoogle Scholar
  13. 13.
    Ho FC, Todd D, Loke SL, Ng RP, Khoo RK (1984) Clinico-pathological features of malignant lymphomas in 294 Hong Kong Chinese patients, retrospective study covering an 8-year period. Int J Cancer 34: 143–148PubMedGoogle Scholar
  14. 14.
    Jaffe ES, Chan JK, Su IJ, Frizzera G, Mori S, Feller AC (1996) Report of the workshop on nasal and related extranodal angiocentric T/natural killer cell lymphomas. Definitions, differential diagnosis, and epidemiology. Am J Surg Pathol 20: 103–111PubMedGoogle Scholar
  15. 15.
    Jaffe ES, Krenacs L, Kumar S, Kingma DW, Raffeld M (1998) Extranodal peripheral T-cell and NK-cell neoplasms. Am J Surg Pathol 111 [Suppl 1]: 46–55Google Scholar
  16. 16.
    Japan Lymphoma Radiation Therapy Group (JLRTP) (2001) Localized aggressive non-Hodgkin's lymphoma of the nasal cavity: a survey by the Japan Lymphoma Radiation Therapy Group. Int J Radiat Oncol Biol Phys 51: 1228–1233PubMedGoogle Scholar
  17. 17.
    Japan Lymphoma Radiation Therapy Group (JLRTP), Oguchi M, Ikeda H, Isoba K (2000) Tumor bulk as a prognostic factor for the management of localized aggressive non-Hodgkin's lymphoma: a survey of the Japan Lymphoma Radiation Therapy Group. Int J Radiat Oncol Biol Phys 48: 161–168PubMedGoogle Scholar
  18. 18.
    Kanavaros P, Lescs ML, Biere J (1993) Nasal T-cell lymphoma: a clinicopathologic entity associated with peculiar phenotype and with Epstein-Barr virus. Blood 81: 2688–2295PubMedGoogle Scholar
  19. 19.
    Kim WS, Song SY, Ahn YC, Ko YH, Baek CH, Kim DY, Yoon SS, Lee HG, Kang WK, Lee HJ, Park CH, Park K (2001) CHOP followed by involved field radiation: is it optimal for localized nasal natural killer/T-cell lymphoma? Ann Oncol 12: 349–352Google Scholar
  20. 20.
    Ko YH, Kim CW, Park CS, Jang HK, Lee SS, Kim SH, Ree HJ, Lee JD, Kim SW, Huh JR (1998) REAL classification of malignant lymphomas in the Republic of Korea. Cancer 83: 806–812CrossRefPubMedGoogle Scholar
  21. 21.
    Kwong YL, Chan ACL, Liang R, Chiang AKS, Chim CS, Chan TK. Todd D, Ho FC (1997) CD+56 NK lymphomas: clinicopathological features and prognosis. Br J Hematol 97: 821–829Google Scholar
  22. 22.
    Liang R, Todd D, Chan TK, Chiu E, Choy D, Loke SL, et al (1990) Nasal lymphoma. A retrospective analysis of 60 cases. Cancer 66: 2205–2209PubMedGoogle Scholar
  23. 23.
    Logsdon MD, Ha CS, Kavadi VS, Cabanillas F, Hess MA, Cox JD (1997) Lymphoma of the nasal cavity and paranasal sinuses: improved outcome and altered prognostic factors with combined modality therapy. Cancer 80: 477–488CrossRefPubMedGoogle Scholar
  24. 24.
    Miller TP, Dahrberg S, Cassady R, Adelstein DJ, Spier CM, Grogan TM, LeBlanc M (1998) Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high-grade non-Hodgkin's lymphoma. N Engl J Med 339: 21–26PubMedGoogle Scholar
  25. 25.
    Ng CS, Chan JK, Lo ST (1987) Expression of natural killer cell markers in non-Hodgkin's lymphomas. Hum Pathol 18: 1257–1262Google Scholar
  26. 26.
    Quraishi MS, Bessell EM, Clark D, Jones NS, Bradley PJ (2000) Non-Hodgkin's lymphoma of the sinonasal tract. Laryngoscope 110: 1489–1492PubMedGoogle Scholar
  27. 27.
    Sakata K, Hareyama M, Ohuchi A, Sido M, Nagakura H, Morita K, Harabuchi Y, Kataura A (1997) Treatment of lethal midline granuloma type nasal T-cell lymphoma. Acta Oncol 36: 307–311PubMedGoogle Scholar
  28. 28.
    Sasai K, Yamabe H, Kokubo M, Shibata T, Oya N, Nagata Y, Hiraoka M (2000) Head-and-neck stages I and II extranodal non-Hodgkin's lymphomas: real classification and selection for treatment modality. Int J Radiat Oncol Biol Phys 48: 153–160CrossRefPubMedGoogle Scholar
  29. 29.
    Shikama N, Izuno I, Oguchi M, Gomi K, Sone S, Takei K, Sasaki S, Wako T, Itou N, Ishii K (1997) Clinical stage IE primary lymphoma of the nasal cavity: radiation therapy and chemotherapy. Radiology 204: 467–470PubMedGoogle Scholar
  30. 30.
    Strickler JG, Meneses MF, Habermann TM, Ilstrup DM, Earle JD, McDonald TJ (1994) Polymorphic reticulosis: a reappraisal. Hum Pathol 25: 659–665PubMedGoogle Scholar
  31. 31.
    Tsang RW, Gospodarowicz MK, O'Sullivan B (2002) Staging and management of localized non-Hodgkin's lymphomas: variations among experts in radiation oncology. Int J Radiat Oncol Biol Phys 52: 643–651CrossRefPubMedGoogle Scholar
  32. 32.
    van de Rijn M, Bhargava V, Molina-Kirsch H, Carlos-Bregni R, Warnke RA, Cleary ML (1997) Extranodal head and neck lymphomas in Guatemala: high frequency of Epstein-Barr virus-associated sinonasal lymphomas. Hum Pathol 28: 834–839PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • J.-S. Woo
    • 1
  • J. M. Kim
    • 1
  • S. H. Lee
    • 1
  • S. W. Chae
    • 1
  • S. J. Hwang
    • 1
  • H.-M. Lee
    • 1
  1. 1.Department of Otorhinolaryngology and Head and Neck SurgeryGuro Hospital, Korea University College of MedicineSeoul Korea

Personalised recommendations