A previously healthy 7-year-old boy was evaluated for a two-month history of purulent rhinorrhea that was unresponsive to multiple courses of antibiotic therapy. The patient also had experienced significant malaise associated with a weight loss of 4 kg. There was no history of epistaxis, allergy, or trauma. Medical history included tonsillectomy and adenoidectomy at 4 years of age.
On physical examination, this lethargic child had profuse purulent nasal drainage. Results of a nasal examination, after removal of secretions, were normal. Speech was characterized by marked hyponasality. Ocular movements were normal, and there was no proptosis. Findings in the neck were normal on palpation. A lateral roentgenogram of the neck was obtained (Fig 1), followed by a computed tomographic (CT) scan (Fig 2).
Denouement and Discussion
Non-Hodgkin's Lymphoma of the Nasopharynx
Fig 1.—Lateral roentgenogram of neck showing mass completely filling and obstructing nasopharynx.Fig 2.—Computed tomographic scan showing widening of right