Clinical analysis of 28 cases with primary nasal non-Hodgkin's lymphoma

Objective To explore the clinical features of primary nasal non-Hodgkin's lymphoma (NHL) and improve the ability of diagnosis. Methods The clinical data of 28 patients with primary nasal NHL were retrospectively analyzed. Results The clinical behavior of the 28 patients were quite different from each other and there were no specific symptoms. According to the types of Ann Arbor's classification system, 24 were stage IE(10 patients with extend IE),2 stage ⅡE,2 stage Ⅳ. Immunohistochemical examination was performed in 23 patients: T-cell origin in 16, T/NK-cell origin in 5, B-cell origin in 2. All specimens were examined by pathology, but 13 out of them were not done when the patients initially came to our department. The rate of clinical misdiagnosis was 46.4% (13/28). Eleven cases were diagnosed as primary nasal NHL by the first pathologic examination, 17 cases by twice or more, two out of 17 even by five times. All cases got their final diagnosis by pathology. Conclusion The clinical behavior of primary nasal NHL is non-characteristic, very similar to chronic rhinitis and sinusitis in early manifestations, and the pathologic findings are not true negative sometimes. This disease is easy to be misdiagnosed. Promoting doctor's knowledge of this disease, exact biopsy report, and immunohistochemical examinations are the key factors to avoiding misdiagnosis.