NON-HODGKINS-LYMPHOMAS OF THE NOSE AND PARANASAL SINUSES IN THE PEDIATRIC POPULATION

Paranasal and nasal neoplasms often elude early diagnosis in the pedia tric population. This report examines 3 cases of nasal and paranasal s inus lymphomas out of 29 lymphomas and lymphoproliferative disorders s een from 1983 to 1990. Diagnostic delays are common. The development o f orbital signs and symptoms often leads to diagnosis. Computed tomogr aphy and magnetic resonance imaging are important in delineating the e xtent of disease and allow appropriate staging. Transnasal biopsy yiel ds the definitive diagnosis, with low associated morbidity. Aggressive chemotherapy and irradiation prolongs survival; with this regimen all of our patients have remained alive, although 1 has residual disease. B-cell lymphomas are more common than T-cell varieties in children. O ne patient demonstrated B-cell immunodeficiency and preleukemia prior to developing primary paranasal sinus non-Hodgkin's lymphoma; this cas e reiterates the systemic nature of lymphoma. Key differences between children and adults in the manifestations of nasal and sinus lymphomas are emphasized.