Japanese Journal of Rheumatology

, Volume 7, Issue 3, pp 183–188

A case of nasal T cell lymphoma with lethal midline granuloma which is clinically indistinguishable from Wegener’s granulomatosis

  • Toshihiro Nanki
  • Ryuji Koike
  • Noboru Mizushima
  • Hitoshi Kohsaka
  • Tetsuo Kubota
  • Nobuyuki Miyasaka
Case Report

DOI: 10.1007/BF03041240

Cite this article as:
Nanki, T., Koike, R., Mizushima, N. et al. Japanese Journal of Rheumatology (1997) 7: 183. doi:10.1007/BF03041240
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Abstract

We describe a patient who developed fever, bilateral otitis media, destructive necrosis of the nasal cavity and multiple lung nodules. The patient fulfilled the American College of Rheumatology (ACR) classification criteria for Wegener’s granulomatosis (WG) and was also diagnosed as having WG by using the ACR classification tree. However, the diagnosis of T cell lymphoma was finally made by cervical lymph node biopsy, 2 years after disease onset. Rheumatologists should therefore aware of the pitfall of using diagnostic criteria and repetitive biopsy is strongly recommended for accurate diagnosis of WG.

Key words

lethal midline granulomaWegener’s granulomatosisnasal T cell lymphomaEpstein-Barr virus

Copyright information

© VSP and Japanese Rheumatism Association 1997

Authors and Affiliations

  • Toshihiro Nanki
    • 1
  • Ryuji Koike
    • 1
  • Noboru Mizushima
    • 1
  • Hitoshi Kohsaka
    • 2
  • Tetsuo Kubota
    • 1
  • Nobuyuki Miyasaka
    • 1
  1. 1.First Department of Internal MedicineTokyo Medical and Dental UniversityBunkyo-ku, TokyoJapan
  2. 2.Division of Immunological Diseases, Medical Research Institute, School of MedicineTokyo Medical and Dental UniversityBunkyo-ku, TokyoJapan