Korean J Otorhinolaryngol-Head Neck Surg.  2007 Dec;50(12):1170-1174.

A Case of B-Cell Lymphoma Combined with Sinusitis in AIDS Patient

• Jang HJ
• Cho KS
• Lee SH
• Roh HJ

Abstract

We report an unusual case of primary extranodal non-Hodgkin's lymphoma combined with sinusitis in an AIDS patient. A 39-year-old male presented with sinusitis as initial manifestation. A nasal endoscopy revealed nasal polyposis with mucopurulent discharge in both middle meatus and paranasal sinus (PNS) CT scans demonstrated pansinusitis without lamina papyracea or skull base defect. He received antiretroviral and antibiotics therapy due to low CD4 count representing immunocompromised state. The patient was not followed up for observation and he returned with reduced right visual acuity and diplopia, and proptosis after 6 months. A PNS CT scan showed bilateral sinonasal polyposis with pansinusitis and soft tissue density in the right orbit and frontal lobe through bone defect of lamina papyracea and skull base. Endoscopic sinus surgery for orbital decompression and biopsy of intraorbital mass was performed under general anesthesia. The mass was infiltrated into orbital contents and was confirmed as an diffused large B-cell lymphoma with anaplastic variant. The patient received radiotherapy because his general condition was poor. Proptosis and ocular pain were decreased; however, he complained of a persistent headache. Brain CT and MRI showed diffused parenchymal edema around brain abscess in the right frontal lobe. Stereotactic evacuation of the right brain abscess was performed. He has no specific complaints for the last 14 months and antiretroviral therapy is concluded at the present.

Keyword

Lymphoma, large-cell, diffuse; Sinusitis; Acquired immunodeficiency syndrome

MeSH Terms

Acquired Immunodeficiency Syndrome
Adult
Anesthesia, General
Anti-Bacterial Agents
B-Lymphocytes*
Biopsy
Brain
Brain Abscess
CD4 Lymphocyte Count
Decompression
Diplopia
Edema
Endoscopy
Exophthalmos
Frontal Lobe
Headache
Humans
Lymphoma, B-Cell*
Lymphoma, Large B-Cell, Diffuse
Lymphoma, Non-Hodgkin
Magnetic Resonance Imaging
Male
Orbit
Radiotherapy
Sinusitis*
Skull Base
Tomography, X-Ray Computed
Visual Acuity
Anti-Bacterial Agents