Clinical characteristics of primary diffuse large B-cell lymphoma of nasal cavity and paranasal sinuses(18 cases analysis)

TANG Yang-ming; BAI Qing-wei; LIN Jin-ying; LAN Mei; XU Li; SHI Ren-zhou

doi:10.3969/j.issn.1002-266X.2015.27.004

Abstract：Objective To summarize the clinical characteristics and treatment outcomes of primary diffuse large B-cell lymphoma ( DLBCL ) of the nasal cavity and paranasal sinuses.Methods The clinical data including the symptoms, clinical stage, laboratory examination, immunophenotype and therapeutic effects of 18 cases were retro-spectively analyzed.Results The nasal obstruction, rhinorrhea, epistaxis and localizing pain of the nasal sinus were the main clinical manifestations.Of all patients, 16 cases were in Ann Arbor stage Ⅰ-Ⅱ, and 2 cases were in Ann Arbor stage Ⅲ-Ⅳ.Meanwhile, thirteen cases had the IPI score 0-1 and five cases had IPI score 2-3.The determina-tion of the Epstein-Barr virus ( EBV) antibody, EBV DNA, and the EBV encoded RNA ( EBV-EBER) was negative. Immunohistochemical studies showed that tumor cells were positive for CD20 (17/18) and CD79a (15/18) in almost cases.The median tumor cell proliferation index Ki-67 was 70%.The treatment for the cases in Ann Arbor stageⅠ-Ⅱ was mainly chemotherapy combined with radiotherapy, while the treatment for 2 cases in Ann Arbor stage Ⅲ-Ⅳwas chemotherapy.Nine patients achieved complete remission ( CR) , including 5 cases of partial remission ( PR) and 4 cases of progressive disease ( PD) .Thirteen cases died and the 3-year and 5-year overall survival ( OS) rates were 39.7%and 23.4%, respectively.Conclusions Most patients with primary DLBCL of the nasal and paranasal sinuses are in Ann Arbor stageⅠ-Ⅱ, with a poor prognosis.There is no evidence of the infection of the Epstein-Barr virus in the cause of the disease.The treatment mainly refers to the primary nodal DLBCL and nasal NK/T cell lym-phoma, but the curative effect of chemotherapy is poor.