鼻副鼻腔悪性リンパ腫7症例の検討

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  • Seven Cases of Malignant Lymphoma of the Nose and Paranasal Sinuses
  • ビフクビクウ アクセイ リンパシュ 7 ショウレイ ノ ケントウ

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This paper deals with seven patients with malignant lymphoma of the nose and paranasal sinuses. They included six males and one female aging from 30 to 70 years. Of the seven patients, the maxillary sinus was thought to be the site of origin in four patients, the sphenoidal sinus in one and the nasal cavity in three. The most frequent histopathological type in this series was reticulum cell sarcoma, but one was lymphosarcoma and another was unclassifiable.<br>According to the criteria of the Ann Arbor classification, two patients were in stage I, two in stage II, two in stage III and one in stage IV. Cheek swelling and epistaxis were the most common chief complaints in six patients. They did not present particularly characteristic clinical symptoms. Cobalt-60 or Linac teletherapy was delivered in a total dose of 1600-6000rads. In addition, non-scheduled chemotherapy including 5-FU, COP, BONP or VEMP was given. In five out of the seven, the initial response to this therapy was favorable. In these patients, 83% (five of the six) died within 16 months of diagnosis and only 14% (one of the seven) survived for five years. With this dismal experience in mind, three principles are proposed for the management of patients with malignant lymphoma of the nose and paranasal sinuses. These consist of (1) exact staging of the disease, (2) planned protocol adjusted to the stage for the therapy and (3) irradiation combined with chemotherapy for patients in stage II.

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