Manraj Khosla, Victoria M Lim, Jamie Bering, Lee Mcghan and Jue Wang
The paranasal sinuses are rare sites for origination of primary Non-Hodgkin’s lymphoma (NHL). Most often, primary paranasal lymphomas are diffuse large B-cell lymphomas (DLBCL) associated with a poor prognosis. This paper describes an uncommon case of ethmoid sinus lymphoma with lateral displacement of the left orbit and involvement of the nasal vault, skull base, and frontal sinuses. Excisional biopsy and flow cytometry findings favored the diagnosis of DLBCL, non-germinal center type. Moreover, CT showed an epigastric mass and enlarged lymph nodes along the left iliac chain and spleen. Radiation therapy was immediately started and the patient achieved significant symptomatic relief after four treatments. Accurate diagnosis of extranodal NHL lymphomas through a thorough history, physical exam, imaging, and immunopathology is necessary to initiate prompt treatment of this rare, aggressive disease.
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