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Case Reports in Hematology
Volume 2015, Article ID 697957, 5 pages
Case Report

Sinonasal Lymphoma Presenting as a Probable Sanctuary Site for Relapsed B Acute Lymphoblastic Leukaemia: A Case Report and Review of the Literature

1Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
2Department of ORL-HNS, Dunedin Hospital, Dunedin, New Zealand
3Southern Community Laboratories, Dunedin, New Zealand
4Department of Haematology, Dunedin Hospital, Dunedin, New Zealand

Received 7 September 2015; Revised 12 November 2015; Accepted 16 November 2015

Academic Editor: Marie-Christine Kyrtsonis

Copyright © 2015 W. Y. Lim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Sinonasal lymphoma is a non-Hodgkin lymphoma (NHL) representing 1.5% of all lymphomas. It presents as an unremitting ulceration with progressive destruction of midline sinonasal and surrounding structures. Poor prognosis warrants early treatment although diagnosis is challenging and frequently delayed. It is usually primary in origin and to our knowledge the sinonasal region has never been reported as a sanctuary site in leukaemia/lymphoma relapse. We present a unique case of B-cell ALL (acute lymphoblastic leukaemia) with late relapse to the nasal septum as a sinonasal lymphoblastic lymphoma and with genetic support for this as a sanctuary site.