Nasal-type NK/T-cell lymphoma in a patient with hidradenitis suppurativa: A case report

Abstract

Background: Nasal-type NK/T-cell lymphoma is a rare but deadly form of non-Hodgkin's lymphoma that initially presents with local symptoms including erythema, swelling, and epistaxis. Due to misdiagnosis and improper treatment with antibiotics, this tumor will frequently expand to involve nearby facial bones and the oropharynx, with characteristic erosion of the hard palate. Even with treatment, mortality rates are high. We present a case of Nasal-type NK/T-cell lymphoma in a patient whose disease was initially attributed to his pre-diagnosed hidradenitis suppurativa (HS). Case description: A 38-year old male presented with several weeks of progressive nasal swelling and redness, which he initially attributed to his pre-existing HS and self-treated with antibiotics. The patient was subsequently prescribed several courses of increasingly broad-spectrum antibiotics without improvement in his symptoms. Alternative non-infectious diagnoses were only given strong consideration once the tumor had grown to involve nearby structures including the maxilla, nasal sinuses, and oropharynx with characteristic erosion of the hard palate. Conclusions: Nasal-type NK/T-cell lymphoma is a rare and frequently misdiagnosed disease that can cause progressive morbidity and death if not properly treated. A broad differential should be maintained when evaluating prolonged nasal inflammation without systemic signs of infection, particularly when symptoms do not improve with antibiotic therapy.

Keywords

• Nasal-type NK/T-cell lymphoma
• Hidradenitis suppurativa
• Misdiagnosis
• Hard palate erosion