Presentation
Nasal obstruction with snoring.
Patient Data
Large lobulated nasopharyngeal soft tissue mass lateralized to the left obliterating the Rosenmuller fossae and Eustachian tube opening bilaterally with anterior extension obstructing the choanae. It elicits a low signal to muscles on T1, intermediate signal on T2 and T2 fat sat with moderate heterogenous enhancement on postcontrast sequences. Small extension to the left maxillary sinus through a focal defect of its medial wall.
Bilateral small cervical lymph nodes (small axis < 10 mm).
Opacification of the left middle ear and mastoid air cells (secondary otomastoiditis).
Mild peripheral mucosal thickening of the maxillary sinuses with mucous retention cysts.
Case Discussion
Large nasopharyngeal soft tissue mass, pathologically proven as Burkitt lymphoma.
Burkitt lymphoma is the most common (40%) type of non-Hodgkin lymphoma in childhood. It is considered endemic in parts of Africa where rates are up to 50 times higher than in the USA.
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