Part 2: Peripheral T-Cell Non-Hodgkin Lymphoma

Eric D. Jacobsen, MD

Dr. Jacobsen is an instructor in Medicine, Harvard Medical School; Attending Physician, Dana-Farber Cancer Institute, Boston, MA.

Question 5

A 36-year-old man was diagnosed with localized NK/T-cell lymphoma, nasal type after presenting with ulceration of the hard palate with subsequent erosion into the sinonasal cavity. A CT scan of the chest, abdomen, and pelvis shows no evidence of disease outside of the sinonasal cavity. A bone marrow biopsy shows no evidence of involvement with lymphoma. The patient has pain at the site of ulceration but is otherwise asymptomatic. Which of the following is the most important first step in management?

  •  Surgical correction of his palatal defect to prevent
    infection during subsequent chemotherapy
  •  Radiotherapy for local disease control
  •  Combination chemotherapy to prevent dissemination of disease
  •  Intrathecal chemotherapy

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