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Inicio Acta Otorrinolaringológica Española Linfomas de fosas nasales, consideraciones clínicas y anatomo-patológicas
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Vol. 54. Issue 1.
Pages 31-38 (January 2003)
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Vol. 54. Issue 1.
Pages 31-38 (January 2003)
Linfomas de fosas nasales, consideraciones clínicas y anatomo-patológicas
Lymphoma of the nasal cavity, clinical and anatomopathological considerations
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3757
F. Márquez1, P. Escobar, J.M. Villacampa, J. Sanabria, R. Gutiérrez, C. Cenjor
Servicio de Otorrinolaringología
C. Méndez*, C. Rivas*
* Servicio de Anatomía Patológica. Fundación Jiménez Díaz. Universidad Autónoma. Madrid
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Resumen

Se presentan 6 casos de linfomas de alto grado que afectaban la cavidad nasal. Clínicamente los síntomas principales fueron obstrucción nasal, epístaxis y rinorrea. La exploración puso de manifiesto una lesión ulcerada en 4 casos (todos ellos linfomas T/NK) y exofítica en los otros dos (linfomas B). La histología fue diagnóstica para linfoma de alto grado en los 6 casos, la inmunohistoquímica reveló que las células atípicas eran T/NK en 4 casos, y B en los dos restantes. Se realizó un estudio de biología molecular buscando reordenamiento para Ig H y receptores de células T, e hibridación in situ para establecer relación con el virus de Epstein-Barr. Los linfomas nasales son tumores de aparición poco frecuente, su extensión es el factor que en mayor medida condiciona el pronóstico. Para diagnosticarlos precozmente su presencia debe sospecharse tanto en lesiones exofíticas (linfomas B) como en necróticas ulceradas (linfomas T/NK).

Palabras clave:
Linfomas no Hodgkin
Linfomas nasales
Tumores nasales
Abstract

Six cases of high-grade lymphoma affecting the nasal cavity are presented. Their main symptoms were nasal obstruction, epistaxis and rhinorrea. Clinical exploration showed an ulcerated lesion in four patients (all of them T/NK cell lymphomas) and an exofitic tumour in the other two (B cell lymphomas). Pathology was diagnostic for high grade lymphoma in all the six cases, immunohistochemical studies revealed that the atypical cells were T/NK in 4 cases and B in the other two cases. Genotypic analysis was done looking for rearrangement of the genes for Ig H or T-cell receptors. In situ hybridisation was done to detect Epstein-Barr virus RNA. Malignant lymphomas arising in the nasal cavity are unusual, its major prognostic factor is the clinical stage at presentation. To perform an early diagnosis this neoplasia must be suspected in the presence of an exofitic tumour (B cell lymphoma) or necrotic and ulcerated lesion (T/NK cell lymphoma).

Key words:
Non-Hodgkin´s lymphoma
Nasal lymphoma
Nasal tumour

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