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Int J Clin Exp Pathol 2011;4(8):799-801

Case Report
Primary diffuse large B-cell lymphoma of the ethmoid sinus

Tadashi Terada

Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan.

Received August 13, 2011; accepted November 1, 2011; Epub November 3, 2011; Published November 30, 2011

Abstract: Malignant lymphoma of the ethmoid sinus is very rare. A case of diffuse large B-cell lymphoma (DLBCL) of the left ethmoid sinus is
presented here. A 79-year-old Japanese man was consulted to our hospital because of head ache and disturbance of left eye movement.
Nasal endoscopy revealed a tumor, and imaging modalities including CT and MRI detected a tumor in the left ethmoid sinus. The tumor was
invasive into left eye and left nose. A biopsy was performed via the nasal cavity. The biopsy revealed a diffuse proliferation of atypical
lymphocytes. The atypical lymphocytes were large and had enlarged hyperchromatic nuclei. Mitotic figures were scattered. Hodgkin’s cells
were absent. Follicular structures were not seen. Immunohistochemically, the tumor cells were negative for cytokeratins (AE1/2, polyclonal, KL-
1, and CAM5.2, Dako) and epithelial membrane antigen, CD3, CD15, CD30, CD45RO, and TdT. In contrast, the tumor cells were positive for
CD20, CD45, CD79α, and p53. KI-67 labeling was 100%. Light chain restriction was present; there were numerous  λ-chain-positive cells,
while κ-chain-positive cells were scant. The pathological diagnosis was DLBCL of the left ethmoid sinus. Imaging of the whole body revealed
no tumors and lymphadenopathy other than the ethmoid DLBCL. The patient was treated with chemoradiation, and is now alive 3 months after
the presentation. In conclusion, a very rare case of DLBCL of the ethmoid sinus was reported.

Keywords: Primary diffuse large B-cell lymphoma, ethmoid sinus

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Address all correspondence to:
Tadashi Terada, MD, PhD,
Department of Pathology
Shizuoka City Shimizu Hospital
Miyakami 1231, Shimizu-Ku, Shizuoka, 424-8636, Japan.
Tel: 81-54-336-1111, Fax: 81-54-336-1315
E-mail: piyo0111jp@yahoo.co.jp