NK-Cell Lymphomas of the Head and Neck Clinical Presentation

Updated: Jun 22, 2021
  • Author: Benjamin Daniel Liess, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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General manifestations of natural killer (NK)/T-cell lymphoma (NKTCL) include the following:

  • Weight loss

  • Fever

  • Fatigue

  • Night sweats

  • Bone pain

Fewer than 20% of patients have B symptoms on presentation.

Head and neck manifestations include the following:

  • Facial pain and swelling

  • Diplopia

  • Decreased visual acuity

  • Orbital swelling

  • Nasal obstruction

  • Nasal septal perforation

  • Purulent nasal discharge

  • Refractory sinusitis

  • Impaired hearing

  • Palatal ulceration

  • Odynophagia

  • Dysphagia

  • Velopharyngeal incompetence (VPI)

  • Trismus

  • Otalgia

  • Facial swelling

  • Dyspnea

  • Hoarseness

Pulmonary manifestations include the following:

  • Cough

  • Breathing restriction

Gastrointestinal (GI) manifestations include the following:

  • Pain

  • Abdominal fullness

  • Early satiety

  • Perforation

  • Hemorrhage

Testicular pain may also be reported, as may nonhealing sores on the skin.


Physical Examination

General findings on physical examination include the following:

  • Ulcerations involving the skin

  • Pallor

Head and neck findings include the following:

  • Cranial neuropathies

  • Visual impairment

  • Orbital mass

  • Proptosis

  • Facial swelling and erythema (midline facial features)

  • Serous otitis media

  • Ulcerations of the palate, tonsil, nasopharynx, and larynx

  • Nasal mass

  • Neck mass

Pulmonary findings include the following:

  • Cough

  • Restricted breathing

GI findings include the following:

  • Hepatosplenomegaly

  • Abdominal mass

A testicular mass may be detected