A case of nasal T cell lymphoma with lethal midline granuloma which is clinically indistinguishable from Wegener’s granulomatosis
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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.
- Burston H: Lethal midline granuloma: is it a pathologic entity?Laryngoscope 69: 1–43, 1959. CrossRef
- Tsokos M, Fauci AS, Costa J: Idiopathic midline destructive disease (IMDD): a subgroup of patients with the ‘midline granuloma’ syndrome.Am J Clin Pathol 77: 162–168, 1982.
- Robinson AC, Fraser I, Bailey Det al.: Idiopathic midline destructive disease—case report and review of the literature.Postgrad Med J 60: 471–473, 1984. CrossRef
- Hirota J, Osaki T, Yoneda Ket al.: Midline malignant B-cell lymphoma with leukemic transformation.Cancer 70: 2958–2962, 1992. CrossRef
- Leavitt RY, Fauci AS, Bloch DAet al.: The American College of Rheumatology 1990 criteria for the classification of Wegener’s granulomatosis.Arthritis Rheum 33: 1101–1107, 1990.
- Harabuchi Y, Yamanaka N, Kataura Aet al.: Epstein-Barr virus in nasal T-cell lymphomas in patients with lethal midline granuloma.Lancet 335: 128–130, 1990. CrossRef
- Kanavaros P, Lescs MC, Briere Jet al.: Nasal T-cell lymphoma: a clinicopathologic entity associated with peculiar phenotype and with Epstein-Barr virus.Blood 81: 2688–2695, 1993.
- Borisch B, Hennig I, Laeng RHet al.: Association of the subtype 2 of the Epstein-Barr virus with T-cell non-Hodgkin’s lymphoma of the midline granuloma type.Blood 82: 858–864, 1993.
- Mishima K, Horiuchi K, Kojya Set al.: Epstein-Barr virus in patients with polymorphic reticulosis (lethal midline granuloma) from China and Japan.Cancer 73: 3041–3046, 1994. CrossRef
- Aozasa K, Ohsawa M, Tomita Yet al.: Polymorphic reticulosis is a neoplasm of large granular lymphocytes with CD3+ phenotype.Cancer 75: 894–901, 1995. CrossRef
- Prokocimer M, Modan M, Rusoshansky Set al.: ProMACE-CytaBOM: combination chemotherapy for diffuse large cell lymphoma.Anticancer Res 9: 1233–1235, 1989.
- Pavlovsky S, Corrado C, Santarelli MTet al.: An update of two randomized trials in previously untreated multiple myeloma comparing melphalan and prednisone versus three- and five-drug combinations: an Argentine Group for Treatment of Acute Leukemia Study.J Clin Oncol 6: 769–775, 1988.
- Fauci AS, Haynes BF, Katz Pet al.: Wegener’s granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years.Ann Intern Med 98: 76–85, 1983.
- Wiik A: Antineutrophil cytoplasmic antibodies in Wegener’s granulomatosis.Clin Exp Rheumatol 11: 191–201, 1993.
- Hausen HZ, Schulte HH, Klein Get al.: EBV DNA in biopsies of Burkitt tumours and anaplastic carcinomas of the nasopharynx.Nature 228: 1056–1058, 1970. CrossRef
- Cabane J, Raphael M, Lamas Get al.: Origin of malignant centrofacial granulomas: surface markers and gene rearrangement of malignant cells.Laryngoscope 101: 998–1001, 1991. CrossRef
- A case of nasal T cell lymphoma with lethal midline granuloma which is clinically indistinguishable from Wegener’s granulomatosis
Japanese Journal of Rheumatology
Volume 7, Issue 3 , pp 183-188
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- Print ISSN
- Additional Links
- lethal midline granuloma
- Wegener’s granulomatosis
- nasal T cell lymphoma
- Epstein-Barr virus
- Industry Sectors
- Author Affiliations
- 1. First Department of Internal Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, 113, Bunkyo-ku, Tokyo, Japan
- 2. Division of Immunological Diseases, Medical Research Institute, School of Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, 113, Bunkyo-ku, Tokyo, Japan