Germinal Center- Like Diffuse Large B cell Lymphoma of the Frontal Sinus Misdiagnosed as a Pott’s Puffy Tumor
(2020) Annals of Case Reports — Vol. 14, n° 7 (2020) (2020)
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- Abstract
- Non-Hodgkin’s Lymphoma (NHL) of the frontal sinus is very rare and early diagnosis is usually made with some delay because of the non-specificity of the clinical presentation and overlapping with other diseases. We report herein the story of a 40-year-old man who presented to the outpatient clinic with pain and swelling of the forehead. The first diagnosis was a subacute rhinosinusitis mimicking a Pott’s puffy tumor. On the CT scan, there was a partial opacity of the left frontal sinus with osteomyelitis of the anterior and posterior tables of the frontal sinuses. He received broad-spectrum antibiotics and systemic glucocorticosteroids. He responded well to the treatment but the symptoms and signs relapsed at the completion of the treatment. A second CT scan was performed but no significant improvement was found compared with the first CT scan. As there was no pus coming from the middle meatus we decided to take specimen for bacteriological and histopathological examination during a therapeutic window. This was done via a supraciliary incision and frontal trephine. The final diagnosis was a diffuse large B cell lymphoma, germinal center B cell like subtype. He underwent 6 cycles of chemoimmunotherapy with R-CHOP and central nervous system prophyllaxis via intrathecal methotrexate. 2 years after the initiation of the treatment the patient is still free of symptom and disease confirmed by serial PET scans.
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Gersdorff, G., De Dorlodot, C., Fervaille, C., Depaus, J., & Eloy, P. (2020). Germinal Center- Like Diffuse Large B cell Lymphoma of the Frontal Sinus Misdiagnosed as a Pott’s Puffy Tumor. Annals of Case Reports, 14(7 (2020)). https://doi.org/10.29011/2574-7754/100381 (Original work published 2020)