Nasal Endoscopic And CT Findings Of Extranodal NK/T Cell Lymphoma Nasal Type And Their Clinical Diagnostic Value

Objective: to analyze the nasal endoscopic and CT findings of Extranodal natural killer(NK)/T cell lymphoma,nasal type(ENKTL),and to evaluate the clinical value of nasal endoscopy and CT in the diagnosis of ENKTL.Methods: They are divided into two groups.1.ENKTL group: the clinical data,nasal endoscopy and CT data of 21 cases of ENKTL confirmed by pathology in the Department of Otorhinolaryngology and head and neck surgery of the first affiliated Hospital of Guangxi Medical University from December 2013 to December 2019 were analyzed retrospectively.2.Other malignant tumor group: The clinical data,endoscopic and CT data of 20 patients with other malignant tumors of nasal cavity and paranasal sinuses confirmed by pathology in the Department of Otorhinolaryngology and head and neck of the first affiliated Hospital of Guangxi Medical University from October 2018 to December 2019 were analyzed retrospectively.The two groups of patients were examined by nasal endoscopy,CT plain scan or enhanced examination,respectively.Nasal endoscopy and CT findings had their own observed indicators.The nasal endoscopic manifestations and CT findings of the two groups were compared and analyzed.Results:1.Nasal endoscopy in ENKTL group: there were 18 cases of nasal endoscopic data,including 12 cases of unilateral lesions(7cases on the right side,5 cases on the left side)and 6 cases of bilateral lesions.8 cases of fresh organisms can be seen.Mucosal changes included mucosal swelling(n=10),purulent secretion(n=14),erosive ulcer(n=8),pseudomembrane(n=4)and scab(n=4).There were changes of inferior turbinate in 6 cases and perforation of nasal septum in 2 cases,Swelling of contralateral nasal mucosa and inferior turbinate in 1 case.CT data of ENKTL group : According to the CT data of 20 cases,all the tumors involved the nasal cavity,unilateral nasal cavity and paranasal sinuses in 13 cases and bilateral in 7 cases.Ethmoid sinus was involved in 9 cases,maxillary sinus in 5 cases,sphenoid sinus in 2 cases,frontal sinus in 3 cases,multiple sinuses in10 cases,nasal and maxillofacial soft tissue in 7 cases,nasopharynx in4 cases,cervical lymph node enlargement in 5 cases and bone destruction in 5 cases.2.Other malignant tumor group: nasal endoscopy: a total of 20 cases of nasal endoscopic data,all unilateral lesions(13 cases on the right,7 cases on the left),18 cases of fresh organisms,mucosal changes: mucosal swelling in 4 cases,purulent secretion in 8 cases,erosive ulcer in 2 cases,crusts in 1 case.Swelling of inferior turbinate in 1 case,Swelling of contralateral nasal mucosa and inferior turbinate in 7 case.CT data: a total of 20 cases of CT data,19 cases involving the nasal cavity.Unilateral nasal cavity and paranasal sinuses were involved in 19 cases(12 cases on the right side,7 cases on the left side)and 1 case on both sides.Maxillary sinus was involved in 20 cases,ethmoid sinus in 13 cases,sphenoid sinus in 5cases,frontal sinus in 6 cases,multiple sinuses in 20 cases,nasal and maxillofacial soft tissue in 10 cases.Intracranial invasion occurred in4 cases and intraorbital invasion in 10 cases.Bone destruction was found in all cases.Cervical lymph nodes were enlarged in 7 cases.3.Comparison of nasal endoscopic results: The changes of unilateral lesion,fresh organism,purulent secretion,mucosal swelling,albuginea,erosive ulcer and inferior turbinate were more common in ENKTL group than in other malignant tumor group,while the swelling of contralateral nasal mucosa and inferior turbinate in other malignant tumor group was more common than that in ENKTL group,and the difference was statistically significant(P < 0.05).4.Comparison of CT results: The maxillary sinus,multiple paranasal sinuses,intraorbital and bone destruction were more common in the other malignant tumor group than in the ENKTL group,and the difference was statistically significant(P < 0.05).Conclusion : 1.ENKTL nasal endoscopic findings are common mucosal lesions,it is not easy to see fresh organisms,and the lesions often involve bilateral nasal cavities.2.From the CT point of view,ENKTL bone destruction is rare and mild,other malignant tumors of nasal cavity and paranasal sinuses involve a wider range of lesions than ENKTL,bone destruction is more common,the scope of destruction is wider.3.Through nasal endoscopy and CT examination,combined with the clinical manifestations and signs of patients,it is helpful to the clinical diagnosis of ENKTL.