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Nasal T-Cell/Natural Killer Cell Lymphoma

CT and MR Imaging Features of a New Clinicopathologic Entity

G. C. Ooi1, C. S. Chim2, R. Liang2, K. W. T. Tsang2 and Y. L. Kwong2

1 Department of Diagnostic Radiology, The University of Hong Kong, Rm. 405, Block K, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China.
2 Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China.



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  		Fig. 1A. —71-year-old man with 6-month history of nasal blockage caused by nasal T-cell/natural killer cell lymphoma. Contrast-enhanced axial CT scan shows large mass filling entire nasal cavity with erosion and deviation of nasal septum, extending anteriorly into nasal ala (arrows).

 


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  		Fig. 1B. —71-year-old man with 6-month history of nasal blockage caused by nasal T-cell/natural killer cell lymphoma. Coronal CT scan using bone algorithm shows bone erosion of medial maxillary walls, bilateral turbinates, and left ethmoidal sinus.

 


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  		Fig. 1C. —71-year-old man with 6-month history of nasal blockage caused by nasal T-cell/natural killer cell lymphoma. Contrast-enhanced axial CT scan caudad to A shows erosion (E) of anterior aspects of superior alveolar bone.

 


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  		Fig. 2. —76-year-old man with 3-month history of nasal blockage and epistaxis caused by nasal T-cell/natural killer cell lymphoma. Unenhanced axial CT scan shows soft-tissue mass in anterior aspects of left nasal cavity that is destroying nasal septum and adjacent left nasal turbinate. Note extensive soft-tissue involvement in left nasal ala and left buccinator space with focal erosion of adjacent left anterior maxillary wall (arrowhead).

 


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  		Fig. 3. —62-year-old woman with 6-week history of nasal blockage and discharge and right cheek swelling caused by stage T4 nasal T-cell/natural killer cell lymphoma. Contrast-enhanced axial CT scan shows disease extension into infratemporal fossa involving masseter (M) and temporalis (T) muscles, pterygoid fossa (P), and right parapharyngeal space (S).

 


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  		Fig. 4D. —47-year-old man with nasal T-cell/natural killer cell lymphoma who presented with nasal blockage and hard palate ulcer. Contrast-enhanced T1-weighted spin-echo MR image (660/20) shows enhancing tissue (arrowheads) in gingivobuccal recesses and in hard palate, which is partially eroded (E).

 


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  		Fig. 4A. —47-year-old man with nasal T-cell/natural killer cell lymphoma who presented with nasal blockage and hard palate ulcer. Axial T1-weighted spin-echo MR image (TR/TE, 900/9) shows isointense soft-tissue mass (M) involving nasal cavity. Note extension to nasal ala, left inferior turbinate, and both medial maxillary walls.

 


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  		Fig. 4B. —47-year-old man with nasal T-cell/natural killer cell lymphoma who presented with nasal blockage and hard palate ulcer. T2-weighted fast spin-echo MR image (5000/84) shows abnormal tissue as heterogeneously hyperintense (arrows), whereas both maxillary antra are markedly hyperintense because of retained secretions.

 


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  		Fig. 4C. —47-year-old man with nasal T-cell/natural killer cell lymphoma who presented with nasal blockage and hard palate ulcer. Contrast-enhanced T1-weighted spin-echo MR image (660/20) shows enhancing inflammatory polyps and mucosa (arrows). Note nonenhancing fluid in maxillary antra. Tumor tissue enhances heterogeneously.

 

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