Paranasal sinus lymphoma: Retrospective review with focus on clinical features, histopathology, prognosis, and relationship to systemic lymphoma

• Published in: Head & neck Vol. 39; no. 6; pp. 1065 - 1070
• Main Authors: Wajda, Brynn N., Rabinowitz, Mindy R., Nyquist, Gurston G., Mardekian, Stacey K., Rosen, Marc R., Rabinowitz, Michael P.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.06.2017
• Subjects: Adult; Age Distribution; Aged; Aged, 80 and over; B-cell lymphoma; Biopsy; Cohort Studies; Combined Modality Therapy; Conservative Treatment; Female; Head and neck; Humans; Immunohistochemistry; Incidence; Lymphocytes B; Lymphoma; Lymphoma, Large B-Cell, Diffuse - epidemiology; Lymphoma, Large B-Cell, Diffuse - pathology; Lymphoma, Large B-Cell, Diffuse - therapy; Male; Middle Aged; nasal; Neck; Neoplasm Invasiveness - pathology; Neoplasm Staging; Paranasal sinus; Paranasal Sinus Neoplasms - epidemiology; Paranasal Sinus Neoplasms - pathology; Paranasal Sinus Neoplasms - therapy; Prognosis; Rare Diseases; Retrospective Studies; review; Risk Assessment; Sex Distribution; Sinus; Sinuses; Smoking; Survival Rate; systemic; Systemic diseases; Young Adult; nasal; systemic; sinus; review; lymphoma
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.24686

ABSTRACT Background Paranasal sinus lymphoma is a rare clinical entity. Methods We conducted a retrospective case series of 68 patients with biopsy‐confirmed paranasal sinus lymphoma with attention on systemic disease association. Results Of 63 patients with paranasal sinus lymphoma, 35 (56%) had systemic involvement. Four patient groups were identified: (1) primary paranasal sinus lymphoma (44%); (2) systemic disease occurring concurrently with paranasal sinus lymphoma (25%); (3) paranasal sinus lymphoma with relapse of preexisting systemic lymphoma (22%); and (4) progression to systemic disease after primary paranasal sinus lymphoma (8%). Most of the patients with systemic disease were diagnosed at 50 + years and had positive smoking histories. There was a trend toward disease activity in the neighboring ocular location. For patients with preexisting systemic lymphoma, the mean time to paranasal sinus lymphoma was 65 months. When systemic lymphoma developed after localized paranasal sinus lymphoma, mean time to progression was 23 months. Diffuse large B cell lymphoma was the most common paranasal sinus lymphoma. Conclusion There is a risk of systemic involvement during the disease course of paranasal sinus lymphoma. Biopsy is the preferred first management step and should precede debulking or mass resection in nonemergent cases. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1065–1070, 2017