Presentation
Epistaxis, left nasal polypoid mass.
Patient Data
A left nasal cavity polypoid soft tissue mass lesion that extends posteriorly, the lesion is seen extending to the nasopharynx involving the fossa of Rosenmuller and partially obliterating the pyriform sinus. Associated scalloping and rarefaction of the lateral nasal wall. Retained secretions at the left maxillary sinus.
The lesion elicits isointense signal in T1, slightly hyperintense signal in T2 with heterogeneous post-contrast enhancement.
Initial differential included aggressive benign lesion such as inverted papilloma and sinonasal carcinoma.
Surgical biopsy was done and histopathology revealed T-Cell Neoplasm with histologic & immunohistochemical (IHC) features consistent with Extranodal NK / T cell lymphoma, Nasal type.
The teaching point, in this case, is to always think about lymphoma in mucosal space lesions of the neck.
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