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Sinonasal Lymphoma - Radiology

last modified on: Thu, 05/02/2024 - 10:59

Updated by Piper Wenzel, BS May 2024

  • Accounts for 0.2% of invasive cancers and 3% of all head and neck cancers (Bitner 2022)
  • B cell lymphoma is more common in the sinuses and Western populations; T-cell lymphoma is more commmon in the nasal cavity and Asian/South American population (Koeller 2016)
  • Occurs more frequently in the nasal cavity, maxillary and ethmoid sinuses than the sphenoid and frontal sinuses (Shirazi 2018, Koeller 2016)
  • Reported to have an average age of presentation of 49 years and male to female ratio of 1.5:1 (Shirazi 2018)
  • Often presents with nonspecific symptoms; does not cause symptoms until more advanced stage (Bitner 2022)
  • High-grade lymphomas may present with nonhealing ulcers, facial swelling, epistaxis, pain, proptosis, or cranial nerve manifestations (Shirazi 2018)
  • Risk factors for Hodgkin's lymphoma: infection with Ebstein-Barr Virus, family history (Shirazi 2018)
  • Risk factors for Non-Hodgkin's lymphoma: autoimmune diseae, HIV/AIDS, human T lymphotropic virus infection, immunosuppressant medication, some pesticides (Shirazi 2018)
  • On CT:
    • Non-contrast: large, nodular mass with soft tissue densities; remodels and/or erodes bone
    • Contrast: enhances homogeneously
  • On MR:
    • T1: intermediate, homogeneous signal
    • T2: intermediate, homogeneous signal
    • T1 post-contrast: moderate enhancement

References

Bitner BF, Htun NN, Wang BY, Brem EA, Kuan EC. Sinonasal lymphoma: A primer for otolaryngologists. Laryngoscope Investig Otolaryngol. 2022 Oct 4;7(6):1712-1724. doi: 10.1002/lio2.941. PMID: 36544932; PMCID: PMC9764779.

Shirazi N, Bist SS, Puri N, Harsh M, Ahmad S. Primary sinonasal lymphoma in immunocompetent patients: A 10 years retrospective clinicopathological study. J Oral Maxillofac Pathol. 2018 May-Aug;22(2):280-281. doi: 10.4103/jomfp.JOMFP_45_17. PMID: 30158788; PMCID: PMC6097383.

Koeller KK. Radiologic Features of Sinonasal Tumors. Head Neck Pathol. 2016 Mar;10(1):1-12. doi: 10.1007/s12105-016-0686-9. Epub 2016 Feb 1. PMID: 26830408; PMCID: PMC4746141.

Sohal RJ, Bem S, Gilligan DM. Primary Sinonasal Lymphoma: A Rare Cause of Cranial Neuropathies. Cureus. 2020 May 15;12(5):e8135. doi: 10.7759/cureus.8135. PMID: 32550055; PMCID: PMC7294899.