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Case report
Extranodal natural killer/T cell lymphoma, nasal type: a diagnostic challenge
  1. Patricia S Gomes1,
  2. Sergio Caselhos1,
  3. Ana Teresa Vide2 and
  4. Rui Fonseca1
  1. 1Otorhinolaryngology, Hospital da Senhora da Oliveira Guimarães, Guimaraes, Braga, Portugal
  2. 2Neuroradiology, Hospital da Senhora da Oliveira Guimarães, Guimaraes, Braga, Portugal
  1. Correspondence to Dr Patricia S Gomes; anapatriciasousagomes{at}


Extranodal natural killer/T cell lymphoma, nasal type (ENKL) is a rare and aggressive tumour that can, clinically and histologically, mimic infectious and inflammatory conditions, presenting a diagnostic challenge. The authors report the case of a 69-year-old Portuguese woman previously misdiagnosed with chronic recurrent sinusitis. Despite maximal medical and surgical treatments, the disease was refractory and progressed. The patient had undergone multiple biopsies when the histopathological diagnosis of ENKL was made, 5 months after the initial complaints. Multiagent chemotherapy was offered, but during the first cycle, the patient developed severe infection and pancytopenia, which culminated in her death. This case highlights the need to consider a neoplastic cause when faced with aggressive sinonasal disease not responsive to maximal treatment and the difficulties in establishing the diagnosis of ENKL, with multiples biopsies of deep-tissue usually being required.

  • head and neck cancer
  • head and neck surgery
  • cancer intervention
  • ear, nose and throat
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  • Contributors PSG, SC and RF contributed to the conception, analysis and interpretation of the data for the work. PG, SC and ATV were responsible for the drafting of the manuscript and all the authors for revising it for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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