A Comparative Study on Clinico-radiological Differentiation of Sino-nasal Squamous Cell Carcinoma (SCC) and Sino-nasal N
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ORIGINAL ARTICLE
A Comparative Study on Clinico-radiological Differentiation of Sino-nasal Squamous Cell Carcinoma (SCC) and Sino-nasal Non-Hodgkins Lymphoma (NHL) Mainak Maitra1 • Mukesh Kumar Singh1
Received: 16 July 2019 / Accepted: 24 August 2020 Association of Otolaryngologists of India 2020
Abstract (1) To compare clinical presentations between sinonasal non-Hodgkins Lymphoma (NHL) and sino-nasal Squamous cell carcinoma (SCC). (2) To compare computed tomographic (CT) scan findings between sino-nasal NHL and sino-nasal SCC. (1) Design: Retrospective Comparative study. (2) Setting: tertiary care hospital. (3) Subjects: patients with histologically proven primary maxillary tumors (NHL and SCC). (4) Method: (a) Patients: medical records between March 2013 to March 2018 were examined and patients with histologically proven primary maxillary tumors (NHL and SCC) were included in the study. (b) CT imaging: unenhanced and contrast enhanced images were obtained for all patients. Unenhanced CT images were reconstructed using bone and soft tissue algorithm. (c) Image Assessment: Predominant growth patterns of the tumors were noted from the CT images. Sino-nasal NHL: 8 men and 3 women; Sino-nasal SCC: 19 men and 5 women. Mean age of the NHL and SCC patients were 66.18 y and 64.88 y respectively. Nasal obstruction, diplopia/blurred vision, nasal/cheek pain and cranial nerve palsies were significantly more common presentation among sino-nasal NHL patients (p values of 0.0053, 0.0014, 0.0089 and 0.0089 respectively). Permeative growth pattern was significantly higher among NHL patients (54.54%) (p value = 0.026) whereas SCCs showed significant destructive growth pattern (83.33%) (p value = 0.0009). Intra-tumoral necrosis was significantly
& Mainak Maitra [email protected]; [email protected] Mukesh Kumar Singh [email protected] 1
Department of ENT and Head Neck Surgery, R G Kar Medical College and Hospital, 1 Khudiram Bose Sarani, Kolkata, West Bengal 700004, India
higher in SCC patients (87.5%) (p value = \ 0.0001). Nasal obstruction, diplopia/blurred vision, nasal/cheek pain and cranial nerve palsies were the predominant presenting features in sino-nasal NHL patients. In CT imaging, Sino-nasal SCCs showed predominantly destructive growth pattern and intra-tumoral necrosis whereas permeative growth was predominant feature of sino-nasal NHL. Keywords Sino-nasal malignancy Squamous cell carcinoma (SCC) Non-Hodgkins lymphoma (NHL) Computed tomography (CT)
Introduction Sinonasal cancers are rare malignant neoplastic lesions of the nose and paranasal sinuses accounting for less than 1% of all malignancies and about 3% of all head and neck cancers [1–3]. They have an incidence of 0.5–1 per 100,000 per year [1]. Most develop in the fifth and sixth decades of life and the incidence in men is twice that of women [4]. The symptoms of sinonasal cancers depend on the site and extent of disease and may initially include nasal obstruction, epistaxis or symptoms consistent with chronic rhinosinusitis s
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