鼻NK/T细胞淋巴瘤的临床及病理学特征分析

目的探讨鼻NK/T细胞淋巴瘤的临床及组织病理学特征。方法对经治的21例鼻腔NK/T细胞淋巴瘤患者临床资料进行回顾性分析，总结其临床特点及组织病理学特征。结果患者主要临床症状表现为单侧鼻塞及脓血涕；经鼻内镜检查，证实肿瘤位于鼻腔外侧壁者17例，位于鼻中隔者4例；肿瘤形状类似于息肉样病变者9例，肿瘤表面糜烂且质脆者12例；CT显示肿瘤居于鼻腔前部者17例，发于鼻中隔者4例；病变累及上颌窦者12例，累及筛窦3例，同时累及上颌窦与筛窦者6例。病理学检查显示鼻型NK/T细胞淋巴瘤15例，外周T细胞淋巴瘤6例。结论本病临床表现缺乏特异性，CT检查有利于确定病变范围及临床分期，多部位活检及免疫组织化学检查是确诊鼻NK/T细胞淋巴瘤的主要依据。

Clinical and pathohistological characteristics of nasal NK/T cell lymphoma-with 21 cases report

Objective To sum up the clinical and pathohistological characteristics of nasal NK/T cell lymphoma based on a clinical survey on a group of cases with this kind of lesion. Methods A retrospective study was carried out among 21 cases with nasal NK/T cell lymphoma, treated in our Hospital from Jun. 2001 to Jul. 2007, to sum up the clinical and pathohistological characteristics of this condition. Results The most commonly seen clinical symptoms included the unilateral nasal obstruction accompanied with bloodish purrelant nasal discharge. It was found that the tumor located in the lateral wall of nasal cavity in 17 cases and on nasal septum in 4 ones as revealed under nasal endoscope, with an appearance of polypoid neoplasm among 9 and of erosion on the surface of tumor with marked fragility in quality among 13. From the CT film, it was shown that the lesion localized in the anterior nasal cavity in 17 patients and derived fi＇om septum in 4, with 12 limited in maxillary sinus, 3 involved in ethmoidal sinuses and 6 reached at a range including both of maxillary and ethmoidal sinuses. However, fifteen cases were pathohistologically determined as nasal type of NK/T cell lymphoma and the other 6 as peripheral T cell lymphoma. Conclusions It is somewhat troublesome that this kind of lesion is lacking disease-specific features for making a more definite clinical diagnosis simply based on its manifestations, while CT scanning may be helpful for evaluating the involved range of lesion and decision making in its clinical phase. Only on the basis of pathohistology made on tissue samples fi＇om a biopsy in multiple locations and on the basis of accessory assay by immunohistochemistry to provide powerful evidences, can a final diagnosis be made for such a condition as nasal NK/T cell lymphoma.