NK-Cell Lymphomas of the Head and Neck Clinical Presentation

Updated: Jan 12, 2016
  • Author: Benjamin Daniel Liess, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Presentation

History

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.

Next:

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

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