Non-Hodgkin’s lymphoma presenting as facial swelling and nasal obstruction in a pediatric patient

Lymphomas account for 13% of all newly diagnosed cancers in children and adolescents. Non-Hodgkin's lymphoma (NHL) represents approximately 60%, with Hodgkin's disease accounting for the remainder. 1 , 2 NHL of the sinonasal tract is relatively rare and accounts for only 1.5% of all NHLs in the United States. 3 NHLs are among the most rapidly growing of all malignancies and often result in progressive mass effect and facial asymmetry. Tumors of the sinonasal tract can give rise to rhinorrhea, sinus infection, epistaxis, nasal obstruction, and proptosis. Sinonasal NHL has often been confused with a number of infectious, autoimmune, and inflammatory diseases. Because NHL is one of the fastest growing tumors, the expeditious diagnosis of NHL is crucial. We report an unusual case of a girl with nasal airway obstruction and facial swelling as the only symptoms of the underlying disease process. This case demonstrates a rare, extranodal lymphocytic lymphoma of the maxillary sinuses and soft tissues of the face.