gms | German Medical Science

79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

30.04. - 04.05.2008, Bonn

CLL manifestation in the paranasal sinuses – presentation of a rare case

Meeting Abstract

Search Medline for

  • corresponding author Johannes Veit - University medical center Hamburg-Eppendorf, Hamburg, Germany
  • Jozef Zustin - University medical center Hamburg-Eppendorf, Hamburg, Germany
  • Judith Dierlamm - University medical center Hamburg-Eppendorf, Hamburg, Germany
  • Michael Jaehne - University medical center Hamburg-Eppendorf, Hamburg, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Bonn, 30.04.-04.05.2008. Düsseldorf, Köln: German Medical Science; 2008. Doc08hno70

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2008/08hno70.shtml

Published: July 8, 2008

© 2008 Veit et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: Chronic lymphatic leukemia (CLL) is one of the most common malign lymphatic diseases of the adult. Usually the disease occurs in the peripheral blood, lymph nodes, or the hematopoetic bone marrow, an occurrence in the paranasal sinuses is extremely rare.

Results: We present the case of a 75 years old female patient who presented with symptoms of persistent frontal, retrobulbary headaches. The computed tomography showed an osteoma of a size of 16x8 mm in the left frontal sinus. As a secondary finding there was a cervical lymph node enlargement. Extra- and endonasale sinus surgery and a diagnostic extirpation of the lymph node were performed. The histopathological work up of the specimens showed extended infiltrations of monoclonal lymphocytes. Immunostaining confirmed the diagnosis of CLL with strong expression of BCL2, CD5, CD20 and CD79a. After completion of the staging Binet-stage B, Ray-stage 1, was noted. Because of manifestation close to the CNS a systemic therapy with fludarabine was started.

Conclusions: CLL within an osteoma of the frontal sinus is a very rare disease manifestation. The characteristics of the presented case emphasize the importance of histopathological work up of bony lesions of the paranasal sinuses, because they might harbour systemic disease. The biological aggressiveness of the tumour can be assessed by fluorescence in situ hybridisation and analysis of gene mutations.