鼻腔及鼻窦MALT淋巴瘤:1例罕见的病例报告及文献复习OA

Objective:To report a rare case of nasal cavity and paranasal sinus mucosa-associated lymphoid tissue(MALT)lymphoma and review relevant literature,summarizing its clinical features,diagnostic approaches,and treatment strategies.Methods:We retrospectively analyzed the clinical presentation,imaging features,histopathology,immunohisto-chemical phenotype,treatment regimen and follow-up data of one patient with nasal and paranasal sinus MALT lymphoma in our hospital,and reviewed relevant literature.Results:A 58-year-old female patient presented with right nasal obstruction accompanied by rhinorrhea,epiphora,and sneezing for one year.CT revealed thickening of multiple sinus mucosa,right deviation of the nasal septum,and bone destruction of the me-dial wall of the left maxillary sinus and inferior turbinate.En-doscopic sinus antrostomy with partial submucosal resection of the nasal septum was performed.Intraoperatively,bilateral ethmoid sinus masses involving the middle nasal meatus were i-dentified and resected for examination.Pathology demonstrated lymphocytic proliferative infiltration of the lamina propria.Immunohistochemistry showed positivity for CD19,CD20,CD23,BCL-2,and Ki-67(10%);negativity for CD3,CD5,CD10,BCL-6,Cyclin D1,and EBER.Clonal rearrangements of IGH,IGK,and IGL genes were detected.Clinical staging was Ann Arbor(Lugano)stage Ⅳ.After treatment with rituximab combined with intensity-modulated radiotherapy(IMRT),the patient remained stable at the 9-month follow-up.Conclusion:MALT lymphoma of the nasal cavity and paranasal sinu-ses is extremely rare.Its clinical presentation lacks specificity,requiring confirmation through histopathology and immunohis-tochemical profiling.For advanced-stage patients,favorable disease control can be achieved following treatment with mono-clonal antibodies combined with radiotherapy.