Abstract
Primary non-Hodgkin lymphoma (NHL) of the paranasal sinuses is a rare neoplasm that cannot be easily diagnosed and differentiated as its clinical, histological, and imaging features are similar to those of other inflammatory and tumorous diseases in their early stages. We evaluated the morphological and functional imaging characteristics of primary NHL of the sphenoid sinus using CT and MR imaging. Morphological CT and MR imaging as well as perfusion CT imaging and proton MR spectroscopy (PRESS technique, TE = 135) was performed in three patients with the histological diagnosis of highly malignant primary B cell lymphoma of the sphenoid sinus. In all patients an inhomogeneous contrast agent enhancement as well as bony erosion of the sphenoid sinus was identified in CT and MR sections. In one patient an infiltration of the adjacent dura was present. The mean blood flow of the lymphomas was 135 ml/min per 100 g tissue, the mean blood volume was 8.06 ml/min, while the mean transit time and the mean permeability surface area product values were 5.11 s and 26.53 ml/min per 100 g, respectively. The mean choline to creatine ratio in the proton MR spectroscopy was 5.7. Cross-sectional imaging findings are not sufficient to establish the diagnosis of a primary NHL in the sphenoid sinus. Physiologic imaging offers valuable information that may be characteristic of the tumor. Future studies may lead to a safe differentiation of the lymphomas from other pathologic entities based on the combination of morphological and functional imaging.
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References
Cleary K, Batsakis J (1994) Sinonasal lymphomas. Ann Otol Rhinol Laryngol 103:911–914
Hans FJ, Reinges MHT, Nolte K, Reipke P, Krings T (2005) Primary lymphoma of the skull base. Neuroradiology 47:539–542
Liang R, Todd D, Chan TK, Chiu E, Choy D, Loke SL et al (1990) Nasal lymphoma. A retrospective analysis of 60 cases. Cancer 66:2205–2209
Roman-Goldstein SM, Jones A, Delashaw JB, McMenomey S, Neuwelt EA (1998) Atypical central nervous system lymphoma at the cranial base: report of four cases. Neurosurgery 43:613–615
Boring CC, Squires TS, Tong T (1993) Cancer statistics. Cancer 43:7–26
Weber AL, Rahemtullah A, Ferry JA (2003) Hodgkin and non-Hodgkin lymphoma of the head and neck: clinical, pathologic, and imaging evaluation. Neuroimaging Clin N Am 13:371–392
Onakoya PA, Adeyi OA, Nwaorgu OG, Ojemakinde KO, Thomas JO (2003) Primary extranodal non-Hodgkin’s lymphoma of the upper aerodigestive tract—a descriptive analysis of the pattern seen in the University College Hospital, Ibadan. Afr J Med Med Sci 32:59–63
Prades E, Alobid I, Alos L, Guilemany JM, Bernal-Sprekelsen M, Mullol J (2003) Extranodal lymphoma originating from mucosa-associated lymphoid tissue of the nasopharynx. Acta Otolaryngol 123:1098–1101
Roth DB, Siatkowski RM (2000) Bilateral blindness as the initial presentation of lymphoma of the sphenoid sinus. Am J Ophthalmol 129:256–258
Nakamura K, Uehara S, Omagari J, Kunitake N, Kimura M, Makino Y et al (1997) Primary non-Hodgkin’s lymphoma of the sinonasal cavities: correlation of CT evaluation with clinical outcome. Radiology 204:431–435
Glenn LW (2005) Innovations in neuroimaging of skull base pathology. Otolaryngol Clin North Am 38:613–629
Law M, Cha S, Knopp EA, Johnson G, Arnett J, Litt AW (2002) High-grade gliomas and solitary metastases: differentiation by using perfusion and proton spectroscopic MR imaging. Radiology 222:715–721
Rumboldt Z, Al-Okaili R, Deveikis JP (2005) Perfusion CT of head and neck tumors: pilot study. AJNR Am J Neuroradiol 26:1178–1185
Bisdas S, Baghi M, Smolarz A et al (2007) Quantitative measurements of perfusion and permeability of oropharyngeal and oral cavity cancer, recurrent disease, and associated lymph nodes using first-pass contrast-enhanced computed tomography studies. Inv Radiol 42(3):172–179
Weber MA, Zoubaa S, Schlieter M et al (2006) Diagnostic performance of spectroscopic and perfusion MRI for distinction of brain tumors. Neurology 66:1899–1906
Maheshwari SR, Mukherji SK, Neelon B, Schiro S, Fatterpekar GM, Stone JA, Castillo M (2000) The choline/creatine ratio in five benign neoplasms: comparison with squamous cell carcinoma by use of in vitro MR spectroscopy. AJNR Am J Neuroradiol 21:1930–1935
King AD, Yeung DK, Ahuja AT, Leung SF, Tse GM, van Hasselt AC (2004) In vivo proton MR spectroscopy of primary and nodal nasopharyngeal carcinoma. AJNR Am J Neuroradiol 25:484–490
Bisdas S, Baghi M, Huebner F et al (2006) In vivo proton MR spectroscopy of primary tumours, nodal and recurrent disease of the extracranial head and neck. Eur Radiol 16(5) (Epub ahead of print)
Russell P, Lean CL, Delbridge L, May GL, Dowd S, Mountford CE (1994) Proton magnetic resonance and human thyroid neoplasia: discrimination between benign and malignant neoplasms. Am J Med 96:383–388
Motoori K, Yamamoto S, Ueda T et al (2004) Inter- and intratumoral variability in magnetic resonance imaging of pleomorphic adenoma. J Comput Assist Tomogr 28:233–246
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Bisdas, S., Fetscher, S., Feller, A.C. et al. Primary B cell lymphoma of the sphenoid sinus: CT and MRI characteristics with correlation to perfusion and spectroscopic imaging features. Eur Arch Otorhinolaryngol 264, 1207–1213 (2007). https://doi.org/10.1007/s00405-007-0322-0
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DOI: https://doi.org/10.1007/s00405-007-0322-0