Extra Nodal Natural Killer Lymphoma Mimicking Canine Fossa Infection - A Clinical Report

Mature Tor natural killer (NK)/T-cell lymphoma makes up only 5% to 18% of all cases of non-Hodgkin lymphoma (NHL). The relative frequency and optimal therapy for these disorders is not well defined. Extra nodal NK/T-cell lymphoma is a distinct entity in the World Health Organization (WHO) classification [1]. It is more prevalent in Asians and Native Americans, occurs most often in adults, and almost always occurs in extranodal sites with a predilection for the upper airway including nasal passages, paranasal sinuses, and nasopharynx [2,3]. Extranasal sites include skin, soft tissue, and the gastrointestinal tract. Extranodal (NK)/ T-cell lymphoma nasal type is a rare entity with an extremely aggressive nature. We report a unique case of extranodal NK/Tcell lymphoma, nasal type, in a 48-year-old Indian male presenting with progressively increasing hemi facial swelling, periorbital edema and uncontrolled diabetes mellitus mimicking Orofacial infection. Our case demonstrates how the acute presentation of an aggressive extranodal NK/T-cell lymphoma, nasal type, can present in a similar fashion to canine space swelling. Through this report we would like to stress on considering an occult malignancy as differential diagnosis in individuals with altered immune function not responding to conventional treatment and also the role of immuno histochemistry in diagnosing such aggressive tumors.